Guidance on Family Medical Leave Policy for Residents
- Grants up to 12 weeks leave in a 12-month period
- Leave Granted for one or more of the following reasons
- Birth of a child and care after such birth for either parent
- Placement of child for adoption or foster care for either parent
- Serious health condition of spouse, child or parent of employee
- Serious health condition of employee(unable to perform job)
- UTHealth Handbook of Operating Procedures FMLA Policy
Sick and Vaction Leave
- Employees must exhaust all sick leave and vacation leave, if applicable, when taking FMLA
- Paid leave counts against the 12-week FMLA entitlement
Request for Family or Medical Leave - to be completed by employee and returned to residency coordinator.
Certification of Health Care Provider - Resident/Fellow -to be completed by health care provider & resident and returned to coordinator.
Certification of Health Care Provider - Family Member - to be completed by health care provider & resident and returned to coordinator.
Certification of Health Care Provider - Family Member with Military Injury - to be completed by health care provider & resident and returned.
Certification of Qualifying Urgency for Military Family Medical Leave- to be completed by the resident and returned with the above form.
Acknowledgement & Approval Form for Family Medical Leave - Completed by Program Director within 5 days of request submission.
Certification of Fitness for Duty - to be completed by health care provider and returned
Time Log- to be maintained by residency program timekeeper.
FMLA Sample Letters(Downloadble Word Documents - may be edited to fit specific situations.)
FMLA Certification Request Letter- Letter from supervisor to employee requesting completion of the Certification of Health Care Provider Form.
FMLA First Letter for Illness - Letter from supervisor to employee regarding FMLA.
FMLA First Letter (Baby) - Letter from supervisor to employee regarding FMLA available for pregnancy leave.
FMLA Middle Letter -Follow-up FMLA letter from supervisor to employee.
FMLA Extension Letter -Letter from supervisor to employee regarding FLMA expiration and options available if additional time is needed.
Human Resources Advising Team
Emil Dela Cruz - Insurance & Benifits Questions - 713-500-5247
April A. Bass - Leave of Absence Paperwork - 713-500-5154