WH-380-F Certification of Health Care Provider for Family Member'
The Family and Medical Leave Act of 1993, As Amended
WH-380-F
Employee Certifications (Serious Health Condition, Recertification, Fitness-for-Duty; Call to Military Active Duty; Qualifying Exigency Due o Call to Military Active Duty; Servicemember Illness/Injuy
OMB: 1235-0003
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1235-0003 can be found here: