Essay on Project Management
The purpose of this document is to provide information for employees to request family and medical leave. The document includes: Page 1 - Employee Instructions - how to request family and medical leave
Page 2 & 3 - Family and Medical Leave Request form
Additional information regarding family and medical leave is available on WINHR on the Life & Disability page in the Review
Your Benefits section.
Review the following Family and Medical Leave (FMLA) information on WINHR. Go to the HR Central page and click the Policies link under the Policies section.
FMLA - Employee Rights and Responsibilities
FMLA - Employee Rights and Obligations Under Nissan's Policies
FMLA - …show more content…
FMLA Request Form
COMPLETE FOR EACH ABSENCE AND SUBMIT BY CLICKING "Submit to HR Service Center" AT THE BOTTOM.
EMPLOYEE'S REQUEST FOR FAMILY MEDICAL LEAVE
You must have at least 12 months of service with Nissan, have worked at least 1,250 hours during the 12 months preceding the leave, and have a qualified absence as noted below.
You must select one from the section below. In addition, you must fill out the accompanying dates or date and times.
Full Consecutive Days Off (Off Full Shift)
You must select one from the section below. If you select that you are caring for an ill or injured family member, you must choose the relationship and date of birth if that relationship is a child.
I have a serious health condition as defined below.
I am requesting time off to care for an ill or injured family member who has a serious health condition as defined below.
Child (include birth date)
I am taking time off to care for a new child in the home (include birth date above).
A serious health condition is any illness, injury, impairment, or physical/mental condition that involves (1) any inpatient
(overnight) hospital care, (2) more than 3 consecutive calendar