Your Rights Under the Family and Medical Leave Act The Family and Medical Leave Act (FMLA) provides an entitlement of up to 12 weeks of job-protected, unpaid leave during any 12-month period to eligible, covered employees for the following reasons: birth and care of the eligible employee's child, or placement for adoption or foster care of a child with the employee; care of an immediate family member (spouse, child, parent) who has a serious health condition; or care of the employee's own serious health condition. It also requires that employee's group health benefits be maintained during the leave. For more information regarding your rights under FMLA, please review the links below. Employee Rights and Responsibilities | Employee's Guide to FMLA | Employee's Guide to Military FMLA FMLA Request for Leave Form FMLA Request for Leave Form Employee FMLA Checklist FMLA Health Care Provider Certification Forms Employee Serious Health Condition Physician Certification Form Family Member's Serious Health Condition Physician Certification Form Certification of Qualifying Exigency for Military Family Leave Certification for Serious Injury or Illness of Current Servicemember for Military Family Leave Certification for Serious Injury or Illness of a Veteran Servicemember for Military Family Leave FMLA Intermittent Timesheet FMLA Intermittent Timesheet Return to Work Form Fitness-For-Duty Form (This form must be completed by your physician prior to your return to work).