Taking Family or Medical Leave


Effective Date: July 1, 2010

Western is committed to supporting employees when they face difficult work/life issues that require the use of leave. This policy applies to all faculty and staff and covers leave requests related to:

  • An employee's own serious medical condition
  • A serious medical condition for an eligible family member or significant other
  • Maternity and parental related leave (including foster care and adoption)
  • Military family leave, and
  • Domestic violence leave

Due to the complex nature of the laws, a Frequently Asked Questions webpage was created to address more specific details as it pertains to a particular type of leave and employee group.



Policy



Procedures

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Required Forms

Maternity or Paternity

  1. Pregnancy Certification - FRM-U5410.03A
  2. Special Leave Request - FRM-U5410.05A

Injury or Illness

  1. Medical Certification (self) - FRM-U5410.03B
  2. Special Leave Request - FRM-U5410.05A

    Before Returning to Work:
  3. Medical Release Form - FRM-U5410.03D

Family Member Illness

  1. Medical Certification (family) - FRM-U5410.03C
  2. Special Leave Request FRM-U5410.05A

Adoption or Foster Care

  1. Verification from Agency handling placement
  2. Special Leave Request - FRM-U5410.05A

Registered Domestic Partner Illness

  1. Medical Certification (family) - FRM-U5410.03C
  2. Special Leave Request - FRM-U5410.05A

Military Family Leave

  1. Military Orders
  2. Special Leave Request - FRM-U5410.05A


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Applicable Federal and State Laws

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Related Resources

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Questions

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2013 Great College to Work For          AHA 2012 Platinum Achievement 2014 Leaders In Health Care Award
Page Updated 10.29.2013