A covered Vermont employer may use this form if it requires an employee to provide a medical certification supporting a request to take family and medical leave for a family member with a serious health condition.
A covered Vermont employer may use this form if it requires an employee to provide a medical certification supporting a request to take family and medical leave for the employee's own serious health condition.
Updated statement and guidance to reflect amendments that expand qualifying reasons for paid family and medical leave benefits to include reasons related to sexual assault, effective October 1, 2024.