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ComplyRight FMLA Family Member Medical Certification Form, Pack of 50 (A1424)

Item: 2548983   Model: A1424
$44.99 Each

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  • Attorney-developed to ensure 100% compliance
  • Form meets all FMLA required elements for Notice of Privacy Practices
  • Size: 17" x 11" folded to 8 1/2" x 11"

Maintain your FMLA readiness with the ComplyRight FMLA Family Member Medical Certification Form

The ComplyRight FMLA Family Member Medical Certification Form allows healthcare providers to verify a family member's health condition to support a request for FMLA leave to care for a family member such as parent, child or next of kin, and is an integral part of your ComplyRight FMLA Administration System.

  • Attorney-developed to ensure 100% compliance
  • Form meets all FMLA required elements for Notice of Privacy Practices
  • Size: 17" x 11" folded to 8 1/2" x 11"
  • Package of 50 forms

HR Form TypeMedical Records Folders

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