The Notice of Eligibility, Rights and Responsibilities, and Medical Certification- Employee form provides employees with information regarding their Family Medical Leave Act (FMLA) and California Family Rights Act (CFRA) eligibility as well as their rights and responsibilities related to taking an FMLA and/or CFRA related leave.
The medical certification portion of the form is for the treating primary care physician to complete on behalf of the employee. While an employee may be eligible for FMLA and/or CFRA, the medical certification provides information of whether the health condition meets the threshold for the leave protections.
