• Download and complete the Request for Family Medical Leave of Absence Form. Return this form to the Human Resources department. (If returning via email, please send to mechelle.earl@hopkins.kyschools.us. The forms could also be dropped off at the Central Office.)
• If you are requesting FML for a serious health condition, your doctor must complete Form WH-380-E (for YOUR health condition) OR WH-380-F (for a family member’s serious health condition). Returning the certifications along with your request expedites the process
• Within five days of receiving your request, the Finance department will send to you (via district email) a “Notice of Eligibility and Rights & Responsibilities” to notify you of your eligibility under the Family Medical Leave. Per board policy 03.12322/03.22322, paid sick leave shall count, as applicable, against the entitlement; however the employee may request to reserve ten days of sick leave.
• If eligible for family medical leave:
  •  If we have not yet received certifications, you have 15 days upon receipt of the “Notice of Eligibility and Rights & Responsibilities” to submit all required certifications.
  •  If we have your certifications already or once we receive your certifications, your leave will be approved and counted towards your FMLA leave entitlement.

Certifications (To be completed by Employee)

• For incapacity due to pregnancy, prenatal medical care of child birth (Indicate on your request form)
• To care for the employee's child after birth, or placement for adoption or foster care (Fact Sheet - Indicate on your request  form)
• To care for the employee's spouse, son or daughter, or parent, who has a serious health condition (Certification of Health Care Provider for Family Member’s Serious Health Condition)
• For serious health condition that makes the employee unable to perform the employee's job (Certification of Health Care Provider for Employee’s Serious Health Condition)

• Employee Rights and Responsibilities under FMLA  [Spanish version]
• FMLA Fact Sheet