Hello D100 Staff
The following is the procedure when requesting Family Medical Leave ( FMLA).
Please complete all of the steps below.
- Log on to: FMLA Questionnaire Form and complete the google form.
- Below are FMLA Documents for your physician to complete with medical information. Download the one pertinent to your situation.
- Send the completed document with original physician signature to Jane Bagus, Assistant Supt. at LaVergne Education Center.
- After all paperwork has been submitted and reviewed you will receive a Letter of Approval or Denial of the requested medical leave via US. mail and email at bsd100.org.
- If you have any questions during this process please contact Jenny Hosty via email at firstname.lastname@example.org or by phone at 708.303.4008.