How Do I Request an FMLA Leave?


Have more questions? Contact the Disability Management Unit (DMU) at 877-443-6362.

  1. Complete the CS-1845 Application for Leave of Absence
  2. Download and have physician complete CS-1844 FMLA Certification of Employee's Serious Health Condition, or CS-1840 FMLA Certification of Family Member's Serious Heath Condition
  3. Return the forms to the DMU via fax: 517-241-6898, or US mail: PO BOX 30003, Lansing, MI 48909.