Leave of Absence Forms

Your Right under the Family and Medical Leave Act of 1993 (please read) 

 

Choose one form below based on your union 

TACSA Leave of Absence Form

TPA Leave of Absence Form

TFT Leave of Absence Form

26M Leave of Absence Form 

26M Leave of Absence Form - Workers' Compensation

26M Short Term Disability Form

Choose one form below for the physician to complete

Certification of Health Care Provider Form (Employee)

Certification of Health Care Provider From (Family Member) 

 

If you would like to apply for a Leave of Absence you must complete one of the above Leave of Absence Forms and a Certification of Health Care Provider Form.  Please send all request to the Human Resource Department.  

If you have any questons please feel free to contact the following:

Shawna Maynard
Administrative Assistant for Certified Personnel (TFT & Contracted Employees)
734-374-1200 ext. 10114

Pattie Resovsky
Administrative Assistant for Non Certified Personnel (26M), TPA, & TACSA
734-374-1200 ext. 10116