| Care for Yourself
This FMLA leave form should be completed when you have or think you have a qualifying condition. Some examples of qualifying conditions are: pregnancy, surgery, cancer or diabetes.
Leave can be taken intermittently or continuously.
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Care for a Family Member
This FMLA leave should be used when a family member has a qualifying condition. Some examples of qualifying conditions are: where a parent needs assistance.
Leave can be taken intermittently or continuously.
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| Exigency Leave
This type of leave should be used for any qualifying exigency arising out of the fact that a covered military member is on active duty or call to active duty status.
Exigency Leave will also permit eligible employees who are family members of a covered military member to take FMLA leave to address the most common issues that arise when a covered military member is deployed, such as attending military-sponsored functions, making appropriate financial and legal arrangements, and arranging for alternative childcare.
Leave can be taken intermittently or continuously.
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Military Caregiver Leave
This leave may be taken by an eligible employee to care for a covered servicemember with a serious injury or illness.
A “covered servicemember” is a current member of the Armed Forces, including a member of the National Guard or Reserves, who is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status, or is otherwise on the temporary disability retired list, for a serious injury or illness incurred in the line of duty on active duty.
Leave can be taken intermittently or continuously.
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