Certification By Health Care Provider For Family Or Medical Leave Page 2
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1
2State of Wisconsin
Office of State Employment Relations
Division of Compensation and Labor Relations
Genetic Information Nondiscrimination Act of 2008 Notification
The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities
covered by GINA Title II from requesting or requiring genetic information of an individual or family member
of the individual, except as specifically allowed by this law including, but not limited, to when the employee
requests leave for a family member’s health condition to (1) document appropriate use of sick leave; and (2)
where "family medical history" is required to the extent necessary to make the medical certification complete
and sufficient under the FMLA and WFMLA.
To comply with this law, we are asking that you not provide any genetic information when responding to this
request for medical information unless it meets the family member exceptions noted above.
‘Genetic information’ as defined by GINA, includes an individual’s family medical history, the results of an
individual’s or family member’s genetic tests, the fact that an individual or an individual’s family member
sought or received genetic services, and genetic information of a fetus carried by an individual or an
individual’s family member or an embryo lawfully held by an individual or family member receiving assistive
reproductive services.
OSER-DCLR-202 (revised 3/6/13)
s. 103.10, Wis. Stats.
Page 2 of 2
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