R.C.S.A. § 31-51rr Appendix A

Forms to use for the Family and Medical Leave Act (FMLA) for Paraprofessionals (Sec. 31-51rr-1et seq.of the Regulations of Connecticut State Agencies) United States Department of Labor Wage and Hour Division (WHD) http://www.dol.gov/whd/forms/index.htm WH-380-E: FMLA Certification of Health Care Provider for Employee’s Serious Health Condition WH-380-E Form & Instruction WH-380-F: FMLA Certification of Health Care Provider for Family Member’s Serious Health Condition WH-380-F Form & Instruction WH-381: FMLA Notice of Eligibility and Rights & Responsibilities WH-381 Form & Instruction WH-382: FMLA Designation Notice WH-382 Form & Instruction WH-384: FMLA Certification of Qualifying Exigency For Military Family Leave WH-384 Form & Instruction WH-385: FMLA Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave WH-385 Form & Instruction WH-385V: FMLA Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave WH-385V Form & Instruction