Federal employment leave

FMLA Family Member Care Certification (Form WH-380-F)

Certify FMLA leave to care for a family member with a serious health condition

Form WH-380-F is the Department of Labor's optional form for certifying that an employee needs FMLA leave to care for a family member with a serious health condition.

Start the walkthrough View the official source

Average time

15-25 minutes

Difficulty

detail-heavy

Best for

Employees and health care providers certifying family-care FMLA leave.

What this form stands for

Return a complete certification to the employee within the employer's deadline.

Use WH-380-E instead if the leave is for the employee's own serious health condition.

What you'll need

Employee and employer details from Section I
Family member name, relationship, and care you will provide (Section II)
Provider medical facts about the patient's condition and leave timing

How the walkthrough is organized

Employer and employee context

Who is requesting leave and certification deadlines.

Your care plan

Family member, relationship, and care you will provide.

Medical condition type

Which serious health condition categories apply to the patient.

Leave amount needed

Treatment dates, incapacity, and intermittent care absence.

Ready to start?

Docgle asks calm, plain-English questions and keeps the official source attached for review.

Start dol-wh-380f-fmla-family-member-healthcare-certification walkthrough