Overview: How to Apply for Family Medical Leave

As a Central Peninsula Hospital employee, you must request family medical leave through the Human Resources office. 

Step 1: Contact Human Resources to begin the process. You may call 907-714-4773 or email hrinquiry@cpgh.org 

Step 2: Human Resources will provide you with a Notice of Eligibility and Rights and Responsibilities, a Health Care Certification Form and an FMLA checklist within five business days (absent extenuating circumstances). This will include details about your eligibility for family medical leave and the specific expectations and obligations for you and your department, which explain any consequences of a failure to meet these obligations. If you are ineligible, Human Resources will provide you a reason. Once your request has been approved, please continue to step 3.

Step 3: In conjunction with your doctor, complete the appropriate forms and disclosure statements to provide proof that you are experiencing a life event that qualifies for family medical leave. 

Step 4: Submit your completed forms to the Human Resources office within 15 days. (Forms my be dropped off or faxed to 907-262-9128)

Step 5: Before you return from leave,obtain medical approval to return to work, which you must submit to Human Resources by the specified deadline.