Family Medical Leave Act forms

Minnesota Department of Human Services employees who are absent from work for four or more consecutive days because of an illness or injury for you or a family member, or if you believe you have a serious health condition that requires intermittent time away from work, Family Medical Leave Act (FMLA) rights might apply. Print the appropriate form below or contact your designated Human Resources leave coordinator or local human resources office to initiate paperwork.

Human Resources leave coordinator