Family and Medical Leave

Administrative Regulation No.133 pertaining to City Policy on Family and Medical Leave Revised and Reissued Effective: June 19, 2022

Publication Date: 06/19/2022
Document Type: Laws Bills and Policies
Sponsor: Department of Personnel

Summary
Administrative Regulation No.133 pertaining to City Policy on Family and Medical Leave Revised and Reissued Effective: June 19, 2022 and relating forms.

Download

  1. pdf Family and Medical Leave Document (235.32 KB)
  2. pdf AR133 Notice of Eligibility and Rights and Responsibilities (101.23 KB)
  3. pdf AR 133 Request for Family/Medical Leave of Absence Form (83.53 KB)
  4. pdf AR 133 Request for Family/Medical Leave of Absence on an Intermittent/Reduced Schedule Leave Basis (83.92 KB)
  5. pdf AR 133 Certification of Health Care Provider for Employee (150.20 KB)
  6. pdf AR 133 Certification of Health Care Provider for Family Member (144.82 KB)
  7. pdf AR 133 Fitness for Duty Medical Certification (123.98 KB)
  8. pdf AR 133 Report of Intermittent/Reduced Schedule Family/Medical Leave Taken (322.99 KB)
  9. pdf AR 133 Request for Military Family/Medical Leave of Absence for Care of Servicemember (85.26 KB)
  10. pdf AR 133 Request for Intermittent/Reduced Schedule Military Family/Medical Leave of Absence for Care of a Servicemember (85.22 KB)
  11. pdf AR 133 Certification for Serious Injury or Illness of Covered Servicemember (151.76 KB)
  12. pdf AR 133 Request for Military Family/Medical Leave of Absence for Active Duty Exigencies (90.72 KB)
  13. pdf AR 133 Request for Intermittent/Reduced Schedule Military Family/Medical Leave of Absence for Active Duty Exigencies (91.18 KB)
  14. pdf AR 133 Certification of Qualifying Exigency for Military Family Leave (83.41 KB)

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