Saint Louis University

Process to Apply for Family Medical Leave (FMLA)

Request for Family Medical Leave Form:

1) Staff Employees

  • Complete form, sign and date
  • Give form to Supervisor to sign and date
  • Email or fax request to HR at fmla@slu.edu or 977-1785. 

2) Faculty Employees

  • Complete form, sign and date
  • Give form to Department Chair to sign and date
  • Email or fax request to HR at fmla@slu.edu or 977-1785. 

FMLA Certification of Health Care Provider Forms:

1) For Employee Self Coverage - Form WH-380-E

Complete Sections I & II of the FMLA Certification of Health Care Provider Form WH-380-E Form. Give the form to your provider to complete the rest and to email/fax completed form to HR at fmla@slu.edu or 977-1785.

2) For Family Member Coverage - Form WH-380-F

Complete page one. Give the form to the family member's provider to complete and email/fax completed form to HR at fmla@slu.edu or 977-1785.

3) For Military Coverage:

Form WH-384 (Certification of Qualifying Exigency)
Form WH-385 (Serious Injury/Illness of Service Member)
Form WH- 385V (Serious Injury/Illness of Service Member)

Complete the form(s) and email/fax completed form to HR at fmla@slu.edu or 977-1785.

After HR receives both forms, the FMLA request will be reviewed and an FMLA Designation Notice will be mailed to the employee's home informing them if they are approved for FMLA or not.

Faculty will receive a Faculty Medical Leave letter. Faculty will report FMLA time taken to the department time keeper.

Staff will submit FMLA time in the timesheet/leave report in Banner Self Service utilizing FMLA earnings code so that time missed will be put into job protected status, i.e. FMLA sick, FMLA Sick Caregiver, FMLA Vacation, or FMLA Unpaid. Since there is no FMLA Unpaid earnings code to select for monthly paid employees, they should call Payroll (977-2384) by the 20th of the month to do early time reporting, once in unpaid status.

If employee will be in unpaid status, he/she should contact the benefits department at 977-2595 to discuss benefit payments.

For any questions regarding FMLA, please contact the HR Leave & Accommodations Consultant at 977-3949 or fmla@slu.edu.



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