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Stephen F. Austin State University

Leave Forms

Leave Forms

Administrative Leave

File size: 22.30 KB

Updated: Wednesday, September 06, 2017

Leave Without Pay Form

Leave without pay of less than 5 working days for faculty and staff may be granted at the discretion of the department subject to approval from human resources.

File size: 262.62 KB

Updated: Monday, January 13, 2020

Leave Without Pay-Presidential Form

The president may grant a leave of absence for 5 or more consecutive days or multiple intermittent leave without pay to faculty and staff after receiving input from the supervising department regarding departmental needs and subject to the following provisions listed in Policy 12.11 Administrative Leave (Faculty and Staff).

File size: 471.58 KB

Updated: Wednesday, March 25, 2020

FMLA Request Form

File size: 30.15 KB

Updated: Thursday, February 14, 2013

FMLA Packet - Self Serious Health Condition

The Certification of Health Care Provider form is to be completed by the employee's health care provider and returned to Human Resources (HR fax number 936.468.1104).

File size: 1323.34 KB

Updated: Friday, August 21, 2020

FMLA Return to Work Release

This form is to be completed by the employee's health care provider and returned to either the employee's department or Human Resources (HR fax number 936.468.1104) prior to the return to work date. Please notify Rebecca Garrett at 936.468.1288 of your return to work release.

File size: 150.62 KB

Updated: Friday, August 07, 2020

FMLA Packet - Dependent Serious Health Condition

The Certification of Health Care Provider form is to be completed by the dependent's health care provider and returned to Human Resources (HR fax number 936.468.1104). The employee completes Section II of the form before giving the form to the dependent's health care provider.

File size: 1128.04 KB

Updated: Friday, August 21, 2020

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 (see Policy 12.18 Sick Leave).

File size: 148.13 KB

Updated: Monday, October 17, 2011

Leave Policies

Administrative Leave (Faculty and Staff)

Vacation Leave

Sick Leave

Family and Medical Leave

Faculty Development Leaves

Overtime and Compensatory Time