Employee Forms

Step 1- Review FMLA Policy

 

Step 2- Complete the FMLA Request Form

 

Step 3- Complete the Employee section of the applicable Medical Certification and submit the entire form to your medical provider:

 

Step 4- If you are on leave for Self please provide a Return to Work slip before your return.

Family Medical Leave

Clark County provides family and medical leave in accordance with the Federal Family and Medical Leave Act (FMLA) and the Wisconsin Family and Medical Leave Act. 

 

When both laws apply, the leaves under state and federal law will run concurrently and the provisions more beneficial to the employee will apply.  Medical leaves that qualify under the FMLA will also run concurrently with leaves under worker’s compensation, short term disability and other laws, as applicable and as allowed by law.

 

An employee who would like to request FML should review the policy included to the left. After reviewing, please begin by completing the Employee Request Form listed below. 

For more information contact the Personnel Office (715) 743-5224.