Leave of absence request form which should be completed by any employee (classified, unclassified or anyone else employed by UWM at least 1000 hours in the past 52 weeks) who is requesting leave for the birth of a child or placement of a child for adoption or foster care; to care for a child, spouse or parent experiencing a serious health condition; or because of the employee's own serious health condition. Should also be completed for any "leave" which is actually a reduced or intermittent schedule for any of the above-stated reasons.
This form should be completed and used in conjunction with a memorandum requesting the leave for unclassified staff and the Leave Without Pay Request/Authorization form for classified staff. It should be submitted by the employee to the supervisor, and further submission to the appointing authority and finally to the Department of Human Resources.
Employee Request Form:
Physician/Practitioner Certification Form:
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Last modified: March 2, 2004