519 FAMILY MEDICAL LEAVE ACT

Permits an eligible employee to take up to 12 weeks FMLA for a qualifying condition to provide support for a covered military member (the employees spouse, son, daughter, parent or next of kin of the employee) serving in the National Guard or Reserve to be used for any "qualifying exigency' arising out of the fact the covered military member is on active duty or called to active duty in support of a contingency operation

A military operation designated by the Secretary of Defense in
which members of the Armed Forces (Active or Reserves) are or may become involved in
military actions, a military operation that results in the call or order to, retention of, active
duty or reserve during war or national emergency as declared by the President or Congress.

A period of incapacity (i.e., inability to work, attend school or perform other regular
daily activities due to the serious health condition, treatment therefore, or recovery) of
more than three consecutive calendar days, and any subsequent treatment or period of
incapacity relating to the same condition,

CONTINGENCY TREATMENTETreatment __________ times by a health care provider, by a nurse or physician'sassistant under direct supervision of a health care provider, or by a provider of
health care services (e.g., physical therapist) under orders of, or on referral by, a
health care provider;

CONTINGENCY TREATMENTTreatment by a health care provider on at least ________ which results in a
regimen of continuing treatment under the supervision of the health care provider.

Any Period of Incapacity Due to Pregnancy or Prenatal CareAny period of incapacity or treatment for such incapacity relating to a chronic serious health
condition. A chronic serious health condition is one which:

Prenatal CareAny period of incapacity or treatment for such incapacity relating to a chronic serious health
condition. A chronic serious health condition is one which:

Prenatal CareAny period of incapacity or treatment for such incapacity relating to a chronic serious health
condition. A chronic serious health condition is one which:

Any Period of Incapacity Due to Pregnancy or Prenatal CareA period of incapacity which is permanent or long-term for which the employee or family
member may not be receiving active treatment. The employee or family member must be
under the ____________ of a health care provider.

Any Period of Incapacity Due to Pregnancy or Prenatal CareAny period of absence to receive multiple treatments (including any period of recovery by a
health care provider or by a provider of health care services under orders of, or on referral
by, a health care provider, either for restorative surgery after an accident or other injury, or
for a condition that would likely result in a period of incapacity of more than _____________in the absence of medical intervention or treatment).

Any Period of Incapacity Due to Pregnancy or Prenatal CareIf any employee is absent for _____________ on unscheduled leave, their supervisor will notify the Human Resources Division’s Medical Section designee by email.

A member of the Armed Forces, including a member of the
National Guard or Reserves, who is undergoing medical treatment, recuperation, or
therapy, is otherwise in outpatient status, or is otherwise on the temporary disability
retired list, for a serious injury or illness.

The individual employee who has been employed by the employer
for at least 12 months, has been employed for at least 1,250 hours of service during the
12-month prior to the start of leave, and is employed at a worksite where 50 or more
employees are employed by the employer within 75 miles of that worksite.

ELIGIBLE EMPLOYEESMust be employed for at least ________, and has been employed for at least _____hrs of service during the 12-month period prior to the start of leave.

ELIGIBLE EMPLOYEEIs employed at a worksite where ___ or more employees are employed by the employer within _____ miles of that worksite.