For Employees

Do you need to take Family Medical Leave for your own Serious Health Condition?




Pregnancy Disability   

Serious Health Condition of Yourself   

Qualifying Exigency 


To apply for Family Medical Leave for Yourself:


  1. 1. Complete the Medical Leave Request Form and forward it to you supervisor.  

2. Complete the Release of Medical Information and submit it along with a blank Medical Certification of Health Care Provider to your physician.

3. Once your Physician has completed your Medical Certification, submit it directly to HRLeaveAdministration.  Please note completed Medical Certifications should not go through your department or supervisor. 

4. If your physician has authorized time loss, prior to being restored to employment you will be required to present a Return to Work certificate.


If you are applying for "Parental leave" to care for your own newborn, foster or adopted child, the Medical Leave Request Form (1) is the only form that is required!


Timekeeping and Accrual Usage:

  • Use of accrued paid leaves runs concurrently with Family Medical Leave and Oregon Family Leave.
  • Employees must use all accrued paid leave, including any paid leave accrued during the employee's qualified leave, prior to commencing any period of unpaid leave, except for provision under parental leave
  • If leave for a Serious Health Condition (Employee or Family Member), employees must use all accrued sick leave prior to using any other accrued leaves.


Required Notice from Employee:

  • Foreseeable Leave (30 days or more) notice required 30 days in advance of leave
  • Foreseeable Leave (less than 30 days in advance) notice required as soon as possible/practical typically within one or two business days of employee knowing
  • Unanticipated or Emergency leave written or verbal notice required 24 hours prior, or within 3 days of returning to work.
  • Family members may give notice on employee's behalf