Fillable Parental Leave Request Form printable pdf download

Parental Leave Request Form

Download a blank fillable Parental Leave Request Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Parental Leave Request Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Parental Leave Request Form

Parental leave is provided to eligible employees to support new parents with additional flexibility and paid time off

to bond with a new child, adjust to their new family situation, and provide increased balance to their employment

and family obligations. To be eligible for parental leave, you must have been employed by the University in a

benefit-eligible status during the entire 12-month period immediately prior to the birth or adoption of a child. In the

case where both parents are Creighton employees, both are eligible for this leave.

Please indicate payroll cycle:

Please check if applicable:

Bi-Weekly

Monthly

Part-time

Resident

Employee Name

Department Name

Special Schedule Needs:

Parental Leave Start Date

Parental Leave End Date

You will need to complete FMLA (Family Medical Leave Act) as it applies to you. You can find the necessary forms at

Family And Medical Leave Request

Certification of Health Care Provider for Employee

Certification of Health Care Provider for Family Member

Short Term Disability Application

You may fax completed forms to 402.280.3113 or you may email to lenorasalts@creighton.edu. You will receive a

copy of approval form; if denied you will receive a copy with explanation. If you have questions or need assistance

please call Lenora Salts at 402.280.4753.

Comments:

Office use only

Human Resource Approval

Employee # _______________

Date of hire:_______________

Signature ______________________________ Date______________

Approved By: ____________

Date Approved:____________

Approved FMLA Hours:_______

Shared/Parental Leave Request Form 07/24/2015

Parental Leave Request Form

Related Articles

Related forms

Related Categories