Family and Medical Leave Act (FMLA)

 

FMLA General Guidelines

An eligible employee may take up to 12 weeks of unpaid family/medical leave within a 12-month period for certain family and medical reasons as specified under the Family and Medical Leave Act (FMLA) of 1993. The 12-month period is measured forward from the first day FMLA leave is taken. An employee is eligible if he/she has worked for Bridgewater State University for at least one year and for at least 1250 hours over the previous 12 months. Upon return from FMLA leave, employees other than key employees must be restored to the same or an equivalent position with equivalent pay, benefits, and other employment terms. For policies and procedures regarding the usage of FMLA please read the FMLA Leave Policy for BSU Employees.

 

FMLA Forms

- FMLA Leave Request Form (To be completed by the employee and signed by the immediate supervisor and then returned to HR)

- FMLA Acknowledgment of Receipt Form (To be signed by the employee and returned to HR)

- FMLA Leave Policy for BSU Employees (For the employee's personal records)

- GINA Information (For the employee's personal records)

- Certification of Health Care Provider for Employee's Serious Medical Condition (To be completed by the employees health care provider and returned to HR)

- Certification of Health Care Provider for Family Members Serious Medical Condition (To be completed by the employees family member's health care provider and returned to HR)

 

Helpful Websites

US Department of Labor Website

Collective Bargaining Agreements

 

Contact Information

Allison Pickup

Bridgewater State University

Office of Human Resources

508-531-6126

allison.pickup@bridgew.edu

 

Last Modified: November 8, 2012