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Employer Section Ii - Health Care Provider Us: What You Should Know

Please contact your employer with this in mind so that your time off requirements will be in accord with your needs and your employer's schedule. A. Notice. You will receive an e-mail notifying you of your FMLA certification within 1 business day of receipt of this form. B. Employer Responsibilities. You must complete all the required steps in Section III if you or your employer elects to use the FMLA-Certification-of-Health-Care-Provider Forms as the health care provider for your employees. While use of this form is optional, this form asks the health care provider for your health care information. A. Notice. You will receive an e-mail notifying you of your FMLA certification within 1 business day of receipt of this form. C. Employer Responsibilities. 1) You and your employer may submit this form at any time during your employment; this form may be completed at any time. 2) If using the Certification-of-Health Care Provider Forms, your employer will have access to your medical information throughout the year. 3) Upon receiving this form, you must complete Section III; A. Request for Leave and Periodic Review. Please note, while you are not required to take FMLA leaves at this point, if you elect to do so you will be notified, and your employer will have access to all of your medical information for the duration of your FMLA leave as defined under the FMLA (or, if using an alternate medical provider, for the course of your leave). B. Notification of Intent to Use the Form. The Notice will provide instructions on the use process and the form, as well as the employee's rights to consult an attorney regarding this process. This notice will also give you the opportunity to provide a statement to the Secretary of Labor and a Notice of Rights. See Appendix A. Notice of Rights. C. Certification of Health Care Provider. The certification form will require you to provide information regarding your employment with one or more entities, and to describe the health care provider that is in charge of your health care (or, if using an alternate doctor, for the course of your leave). Your certification form will be submitted to the health care provider.

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