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Certification of Health Care Provider for 
Employees’s Serious Health Condition 
under the Family and Medical Leave Act WH-380-E

ICR 202605-1235-003 · OMB 1235-0003 · Object 169358200.

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Document Metadata
File Typeapplication/pdf
File TitleCertification of Health Care Provider for 
Employees’s Serious Health Condition 
under the Family and Medical Leave Act WH-380-E
SubjectWHD
AuthorU.S. Department of Labor
Last Modified ByDesigner 6.5
File Modified2023-02-08
File Created2023-01-25
Conversion Statecomplete
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