Complete this form to be best of your ability, understanding that submitting this request is the starting point to request a leave of absence. Human Resources will follow-up with you and your supervisor/department chair.
Medical Leave of Absence, including FMLA
Kalamazoo College provides eligible employees who are covered under the Family and Medical Leave Act (FMLA) with job protected leave for qualifying reasons. Leaves of absence under this policy shall be administered and provided for in a manner consistent with the FMLA and its published regulations. Employees are eligible if they have worked for the College for at least one year and have worked at least 1,250 hours over the previous 12 months.
Steps
- Request a leave of absence by completing the Medical Leave of Absence Request Form. A paper form may also be requested by contacting Human Resources at HR.Benefits@kzoo.edu.
- Receive preliminary response from Human Resources
- Formal acknowledgement of the leave request
- Medical certification form to be completed by your health provider, usually within 15 calendar days
- HIPAA release, acknowledging that Human Resources (only) will be in receipt of limited information related to your medical condition
- Receive final response from Human Resources after the above pieces are completed and submitted to Human Resources
Related Information
New Child Leave, including FMLA
Kalamazoo College provides eligible employees who are covered under the Family and Medical Leave Act (FMLA) with job protected leave for qualifying reasons. Leaves of absence under this policy shall be administered and provided for in a manner consistent with the FMLA and its published regulations. Employees are eligible if they have worked for the College for at least one year and have worked at least 1,250 hours over the previous 12 months.
Steps
- Request a leave of absence by completing the Medical Leave of Absence Request Form. A paper form may also be requested by contacting Human Resources at HR.Benefits@kzoo.edu.
- Receive preliminary response from Human Resources
- Formal acknowledgement of the leave request
- Medical certification form to be completed by your health provider, usually within 15 calendar days
- HIPAA release, acknowledging that Human Resources (only) will be in receipt of limited information related to your medical condition
- Receive final response from Human Resources after the above pieces are completed and submitted to Human Resources
Related Information
All other types of Leaves of Absence
Kalamazoo College recognizes that there are various reasons why a leave of absence may be requested, including extended Medical Leave, Military Leave, Military Family Leave, or Personal Leave. Please contact Human Resources at hr.benefits@kzoo.edu about these types of leave.
Related Information
Leave of Absence and Pay Continuation Request
Please login to complete and submit this form. If you cannot recall your username and/or password, please contact the Help Desk or visit their accounts and passwords website: https://is.kzoo.edu/network/accounts/.