§ 5. RECEIPT FOR FMLA FORMS.

 

I,                                                          , hereby acknowledge receipt of the FMLA forms. The forms included are the mandatory employee notice, employee FMLA leave request and the FMLA medical certification. I understand that the forms must be completed in full by myself and my medical provider, and must be submitted in a timely manner.                                                                                                                                                                                 (Employee Signature)                                       (Date)                                                                                                                                                                                 (Supervisor or Designee Signature)                              (Date)