Central Connecticut State University (CCSU): Family & Medical Leave Forms

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HR Redirect > Forms > Family & Medical Leave Forms

page tools :

Human Resources Home

FAMILY & MEDICAL LEAVE FORMS

Employee Request Form (HR-1)

Employee Medical Certificate (P-33A)
Caregiver Medical Certificate (P-33B)
Intent to Return to Work (HR-3)

FMLA RESOURCES

Employee Rights & Responsibilities Under the FMLA

FMLA Summary: State & Federal Information

Understanding Family & Medical Leave

Sick Leave Bank Application Forms

AAUP & Management/Confidential SLB Application Form
- See AAUP contract Article 13.3; see M/C HR Policies Article 8.5.3
SUOAF SLB Application Form
- See SUOAF contract Article 24.2.10.

Contact Norma Rivera in Human Resources, at (860)832-2305, for FMLA information.

HUMAN RESOURCES

Hours: 8:00 AM-5:00 PM

Friday: 8:00 AM-4:30 PM

Davidson Hall Room 119

Phone: (860) 832-1756

Fax: (860) 832-2342

Davidson Hall Room 101

Phone: (860) 832-1751

Fax: (860) 832-3197

ING Financial Counseling Sessions

(by appointment only)

Marty Baron

Marty.Baron@ingfp.com

(860) 580-1606

Jan. 16 & 22

Feb. 6, 14 & 25

March 5, 14 & 27

EAST HALL

CONFERENCE ROOM #3

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Faculty / Staff Directory

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