Family Medical Leave (FML) Sample Letters for Academic Appointees

Sample letters for Family Medical Leave (FML) including Pregnancy Disability Leave (PDL), military caregiver, and parental leave.

  1. Employee Not FML Eligible — For All FML Requests except PDL (Pregnancy Disability Leave)
  2. Employee FML Eligible but Leave Entitlement Exhausted — For All FML Requests except PDL
  3. Employee FML Eligible — For Leave for Employee’s Serious Health Condition
  4. Employee FML Eligible — For Leave for Family Member’s Serious Health Condition
  5. Employee FML Eligible — For Military Caregiver Leave
  6. Employee FML Eligible — For Qualifying Exigency Leave
  7. Employee FML Eligible — For Parental Leave when Employee is not birth mother
  8. Employee FML Eligible — For Combined PDL and Parental Leave
  9. Employee Not FML Eligible — For Requests for PDL only
  10. Employee FML Eligible but Leave Entitlement Exhausted — For Requests for PDL only
  11. Employee FML Eligible — For Requests Limited to PDL
  12. Certification and/or Declaration Not Received — For all FML Leaves
  13. Certification Incomplete or Insufficient — For all FML Leaves
  14. Designation Letter — For All Approved and Denied FML Requests except Approved Requests for Combined PDL and Parental Leave
  15. Designation Letter — For Approved Combined PDL and Parental Leave
  16. PDL Confirmation Letter — Employee Not FML Eligible or Employee FML Eligible but Leave Entitlement Exhausted
  17. Letter for Change in End Date of PDL — For Approved Combined PDL and Parental Leave
  18. Re-certification — For Leave for Employee’s or Family Member’s Serious Health Condition

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