Form

Alternate Work Schedule Form

November 1, 2015

File

DHR-Alternative_Work_Schedule_Form.pdf (196.83 KB)

Notice of Eligibility and Rights & Responsibilities (WH-381)

August 29, 2018

File

WH-381 Notice of Eligibility and Rights and Responsibilities FMLA Form.pdf (225.92 KB)

Designation Notice (WH-382)

August 29, 2018

File

WH-382 FMLA Designation Notice.pdf (124.77 KB)

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

August 29, 2018

File

WH385V Military Caregiver Leave Certification for Serious Injury or Illness of a Veteran FMLA Form.pdf (148.27 KB)

Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave (WH-385)

August 29, 2018

File

WH-385 Military Family Leave Certification for Serious Injury or Illness of a Current Servicemember FMLA Form.pdf (103.13 KB)

Certification of Qualifying Exigency For Military Family Leave (WH-384)

August 29, 2018

File

WH-384 Military Family Leave Certification of Qualifying Exigency FMLA Form.pdf (147.59 KB)

Certification of Health Care Provider for Family Member’s Serious Health Condition (WH-380-F)

August 29, 2018

File

WH-380-F Family Member's Certification of Health Care Provider for Serious Health Condition FMLA Form.pdf (202.09 KB)

Certification of Health Care Provider for Employee’s Serious Health Condition (WH-380-E)

August 29, 2018

File

WH-380-E Employee Certification of Health Care Provider for Employee's Serious Health Condition FMLA Form.pdf (490.73 KB)

Request for Salary Advance Form

October 23, 2017

File

DHR-VTHR_Request_for_Salary_Advance_Form.docx (56.03 KB)

Request for Hire into Range

March 7, 2016

File

DHR-Request_for_HIR_Form.pdf (69.37 KB)

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