Form · Leave

FMLA forms (WH-380-E and WH-380-F)

What it is, who uses it, and field-by-field help. Publisher: U.S. Department of Labor, Wage and Hour Division. Links checked October 23, 2026.

Quick answer

The Department of Labor's FMLA medical certification forms are WH-380-E (the employee's own serious health condition) and WH-380-F (a family member's). An employer may require one; it must give at least 15 calendar days to return it. The completed form goes back to the patient, never to the DOL. Use of the DOL form itself is optional.

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At a glance

Forms: WH-380-E (employee), WH-380-F (family member), revised June 2020
OMB number: 1235-0003
Time to return: At least 15 calendar days
Send to: Return to the patient. Do not send to the DOL.
Rule: 29 CFR 825.306 (content of medical certification)
Get the form: DOL FMLA forms page

Who uses it

Employers requesting certification
Employees requesting FMLA leave
Health care providers who certify the condition

Which form

WH-380-E: Leave for the employee's own serious health condition.
WH-380-F: Leave to care for a spouse, parent, or child with a serious health condition.

Questions

Does an employer have to use the DOL FMLA form?

No. The forms say their use is optional, but they ask for what a complete certification needs under 29 CFR 825.306.

How long do I have to return an FMLA form?

The employer must allow at least 15 calendar days, unless that is not feasible despite the employee's diligent, good faith efforts.