FMLA LEAVE REQUESTS

Employees who are eligible (employees must have worked in the District for at least 12 months and have worked at least 1,000 hours to qualify for WFMLA and 1,250 hours for FMLA during the year immediately preceding the effective date of the leave) may request FMLA leave. After notifying their supervisor, employees should contact the Human Resources Administrative Assistant, who will assist the employee in the process of requesting leave. Benefit details pertaining to leave requests will be provided by the payroll office. Additional leave information can be found in the Employee Handbooks.

US Department of Labor - Employee's Certification of Healthcare Provider

US Department of Labor - Family Member's Certification of Healthcare Provider

Return To Work Form (Physician's form is acceptable)

If your physician requires a job description, please contact Human Resources to request a copy of the description for your job classification.

EXTENDED LEAVE REQUESTS (greater than 12 weeks)

Employees may apply for an extended leave for medical reasons or other extenuating circumstances. It is critically important that any employee considering an extended leave communicate that possibility with his/her immediate supervisor and fill out the Cedarburg School District Extended Leave Request Form and submit it to  the Human Resources Department as far in advance as possible. Such applications will be reviewed, processed and granted or denied at the sole discretion of the Director of Human Resources.

Extended Leave Request Form

US Department of Labor - Employee's Certification of Healthcare Provider

US Department of Labor - Family Member's Certification of Healthcare Provider

Return To Work Form (Physician's form is acceptable)

If your physician requires a job description, please contact Human Resources to request a copy of the description for your job classification.

NON FMLA LEAVE REQUESTS

Employees who are not eligible for leave under the state or federal FMLA, may apply for a leave of absence for medical reasons or due to other extenuating circumstances. After notifying their supervisor, employees should contact the Human Resources Department Administrative Assistant, who will assist the employee in the process of requesting leave. 

For more information regarding Extended Leaves, click on the links below, review the Employee Handbook and contact the Human Resources Department.

US Department of Labor Website

WI Department of Workforce Development

US Dept of Labor - Employee Rights and Responsibilities

US Department of Labor - Employee's Certification of Healthcare Provider

US Department of Labor - Family Member's Certification of Healthcare Provider

Return To Work Form (Physician's form is acceptable)

If your physician requires a job description, please contact Human Resources to request a copy of the description for your job classification.