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This form is to be completed by the eligible employee so that they may request to be placed on FMLA.
Complete the form, notifying Human Resources of the date of your return to work. For your own serious health condition, the fitness... More… Complete the form, notifying Human Resources of the date of your return to work. For your own serious health condition, the fitness for duty certification should be completed by your Health Care Provider and returned to Human Resources on your first day back to work after FMLA. Less…