Guides · FMLA certification

FMLA paperwork for doctors: which form you are holding, and what it needs from you

By Kevin Lease, MD · Internal medicine · Published October 1, 2026

When a patient asks you to fill out their FMLA paperwork, they are asking for a medical certification under the Family and Medical Leave Act (FMLA). Their employer can require one before it approves job-protected leave, and it has to come from a health care provider, so it lands on you. This guide is for the clinician, and for the front-desk staff, who have the form in hand. It covers which form it is, what you have to answer and what you do not, the deadlines, the time-off questions that cause the most trouble, and what to do when you do not have the information you need. The field-by-field detail is in the guides for each form.

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Which form are you holding?

The Department of Labor publishes four FMLA certification forms that reach a clinician. The form number is printed at the top of page 1. All four are the June 2020 revision, and all four say in capitals to return the completed form to the patient and not to the Department of Labor.

The employer’s own form, or an insurer’s. The Department of Labor’s forms are optional. Many employers, and the insurers and leave administrators that run leave for them, send their own form instead. That is allowed as long as it asks for the same basic information, and it may not require anything beyond what the regulations allow. In practice the questions are the same ones in a different layout, so the guidance below still applies. 29 C.F.R. § 825.306(b)

The military caregiver forms also ask questions only military records can answer, such as whether the injury was incurred in the line of duty. If you cannot answer those, the regulation lets you rely on what an authorized Department of Defense or VA representative has determined. 29 C.F.R. § 825.310(b)

Who can fill it out

The clinician who treats the patient. For the WH-380-E that is the employee’s clinician, and for the WH-380-F it is the family member’s, which means you may never meet the employee who needs the leave. The regulations count doctors of medicine and osteopathy, and also nurse practitioners, physician assistants, nurse-midwives, clinical social workers, clinical psychologists, podiatrists, dentists and optometrists, as long as they are authorized to practice in the state and are working within their scope of practice. Chiropractors count only for a narrow kind of spinal treatment. For the military caregiver forms, a Department of Defense, VA or TRICARE provider can complete it, and so can any of the clinicians above. 29 C.F.R. §§ 825.125, 825.305(a), 825.310(a)

What you must answer, and what you need not

The regulations list what a certification can ask of you, and the forms follow that list. Basically it comes down to three things.

1. Who you are. Your name, address, phone, fax and type of practice.
2. The condition. When it started, how long it will probably last, and enough medical facts to support the need for leave.
3. The time off. For the employee’s own condition, that they cannot do one or more of the core duties of their job, and for how long. For a family member, that the family member needs care and how much leave that care takes. If the time off comes and goes, that it is medically necessary that way, with an estimate of how often and how long.

29 C.F.R. § 825.306(a)

And what you do not have to give:

• The diagnosis. The forms say you may, but are not required to, add medical facts such as the diagnosis, and they warn that some state and local laws may not allow you to disclose it. My approach is to leave it off and describe the symptoms and the time they cost instead.
• Genetic information or family history. This one is not optional. The forms tell you not to include genetic test results, genetic services, or disease in the employee’s family members, because of the Genetic Information Nondiscrimination Act (GINA). 29 C.F.R. § 1635.3
• Anything beyond the form. Once you have sent back a complete form, the employer may contact you only to confirm that you completed it or to ask what an answer means. They may not ask you for more than the form asks, and the call may never come from the employee’s direct supervisor. 29 C.F.R. § 825.307(a)
• A certification to bond with a healthy baby. The WH-380-E and WH-380-F tell employers they may not ask for a certification for leave to bond with a healthy newborn or a child newly placed for adoption or foster care. If you are handed one for that, it is worth telling your patient so they can ask HR about it.

The deadlines

The employee generally has at least 15 calendar days from when the employer asked to get the completed form back, unless that is not practicable despite their diligent, good faith efforts. If HR finds an answer missing, or too vague to use, they have to tell the employee in writing what is wrong and allow seven more days to fix it. If the corrected form still falls short, the leave can be denied. 29 C.F.R. §§ 825.305(b), 825.305(c), 825.313

The clock starts when HR asks, not when the form reaches your office. That is why I would rather have the front desk book a visit within a couple of days than let a form sit in a tray.

The form also comes back. For the employee’s own condition or a family member’s, HR can generally ask for a new certification no more often than every 30 days and only in connection with an absence, with some exceptions, and in all cases every six months in connection with an absence. They can also ask for a new one each leave year. The two military caregiver forms say recertification is not allowed. 29 C.F.R. §§ 825.305(e), 825.308

Intermittent leave: how often and how long

Intermittent leave is time off in separate blocks for one reason, rather than one continuous stretch. It covers things like a migraine that keeps your patient home a day or two at a time, a weekly infusion, or a daughter who is called away whenever her father falls. The regulations require it to be medically necessary to take the leave that way. 29 C.F.R. § 825.202

This is the question that causes the most trouble. The WH-380-E and WH-380-F split it in two. Planned treatment goes in one item, with the dates or the schedule. Unpredictable episodes, such as flare-ups, go in another, and that item asks for two numbers over the next six months, how often the episodes are likely to come (times per day, week or month) and how long each one is likely to last (hours or days). It needs both. “Migraines about twice a month, one to two days each” is a complete answer. “As needed” is not, and how often without how long, or the reverse, is one of the most common reasons a form is not accepted. 29 C.F.R. § 825.306(a)(6)–(8)

Nobody has a crystal ball, so this is your best educated estimate. I settle the numbers with my patient in the room, because an estimate from the chart alone is often lower than what they actually need, and then the form comes back to be amended. On the WH-380-F, the numbers are about how often the employee needs to be away to care for your patient, which can be more often than your patient is ill, for example when the care is shared with someone else. 29 C.F.R. § 825.124(c)

When you do not have the information

Most FMLA paperwork arrives in one of two ways, handed to you at the end of a visit about something else, or left at the front desk with no word about why the leave is needed. Either way I usually do not have what the form asks for, and here is what I do.

• Book a short visit for the form. If it will take more than about five minutes and there is no time, I tell my patient I want to help and that doing it properly needs a visit in the next couple of days. For a WH-380-F, I ask the caregiver to come too, with my patient’s permission, since they know best what help is needed.
• Teach the front desk the same rule. When a form is dropped off, staff explain that a visit is needed and schedule it within a couple of days, because the 15 days are already running.
• Leave the other sections alone. If the employer’s or the employee’s part is blank, it stays blank. Complete your section and tell your patient what still needs filling in.
• Give a review date rather than a blank. If you truly cannot estimate an end date yet, for example while waiting on a specialist, write the date you will reassess and say why. An empty box reads as “unknown”.
• Do not guess the job. On the WH-380-E, if the employer did not describe the job on page 1, go by what your patient tells you the job involves.

If the form comes back for a small change, such as a different number of flare-ups a month, in my experience HR will usually accept the correction on the original form, crossed out with a single line, initialed and dated.

Fees, chatbots and the field-by-field guides

• How to fill out Form WH-380-E, field by field, for the employee’s own condition.
• How to fill out Form WH-380-F, field by field, for a family member’s condition.
• Can you charge for FMLA paperwork? Who pays under the regulations, and how to set a fee policy.
• Should you use ChatGPT to fill out FMLA paperwork? What a chatbot can and cannot do with this form.

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