Conn. Agencies Regs. tit. 31, 51rr, app A

Current through October 16, 2024
Appendix A

Forms to use for the Family and Medical Leave Act (FMLA) for Paraprofessionals

(Sec. 31-51rr-1et seq.of the Regulations of Connecticut State Agencies)

United States Department of Labor Wage and Hour Division (WHD)

http://www.dol.gov/whd/forms/index.htm

WH-380-E: FMLA Certification of Health Care Provider for Employee's Serious Health Condition

WH-380-E Form & Instruction

WH-380-F: FMLA Certification of Health Care Provider for Family Member's Serious Health Condition

WH-380-F Form & Instruction

WH-381: FMLA Notice of Eligibility and Rights & Responsibilities

WH-381 Form & Instruction

WH-382: FMLA Designation Notice

WH-382 Form & Instruction

WH-384: FMLA Certification of Qualifying Exigency For Military Family Leave

WH-384 Form & Instruction

WH-385: FMLA Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave

WH-385 Form & Instruction

WH-385V: FMLA Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave

WH-385V Form & Instruction

Conn. Agencies Regs. tit. 31, 51rr, app A

Effective May 12, 2014