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Stephen F. Austin State University

Leave Forms

Leave Forms

Leave Without Pay Form

File size: 74.84 KB

Updated: Thursday, May 31, 2012

FMLA Request Form

File size: 30.15 KB

Updated: Thursday, February 14, 2013

FMLA Packet - Self Serious Health Condition

This form is to be completed by the employee's health care provider and returned via fax to 936.468.7056.

File size: 205.24 KB

Updated: Thursday, February 14, 2013

FMLA Packet - Dependent Serious Health Condition

This form is to be completed by the dependent's health care provider and returned via fax to 936.468.7056. There is a section for the employee to complete, also.

File size: 186.81 KB

Updated: Thursday, February 14, 2013

FMLA Packet - Adoption/Foster Care

File size: 59.54 KB

Updated: Thursday, February 14, 2013

FMLA Packet - Qualifying Exigency Military Leave

File size: 173.00 KB

Updated: Thursday, February 14, 2013

FMLA Packet - Military Caregiver Leave (Active Duty)

A covered servicemember is a current member of the Armed Forces, including a member of the National Guard or Reserves, who is receiving medical treatment, recuperation, or therapy, or is in outpatient status, or is on the temporary disability retired list for a serious injury or illness.

This leave allows for 26 work weeks of leave.

File size: 273.47 KB

Updated: Friday, February 15, 2013

FMLA Packet - Military Caregiver Leave (Veteran)

A veteran who is undergoing medical treatment, recuperation, or therapy for a serious injury or illness is a covered veteran if he or she:

• was a member of the Armed Forces (including a member of the National Guard or Reserves);
• was discharged or released under conditions other than dishonorable; and
• was discharged within the five-year period before the eligible employee first takes FMLA military caregiver leave to care for him or her.

This leave allows for 26 work weeks of leave.

File size: 196.05 KB

Updated: Friday, February 15, 2013

Sick Leave Pool Request Packet

Employees may not request an award from the sick leave pool until they have exhausted all of their available leave balances.

File size: 148.13 KB

Updated: Monday, October 17, 2011

Leave Policies