Request for Family and Medical Leave
UK HealthCare employees should submit paper copies of the form to UK HealthCare FMLA administrator at firstname.lastname@example.org or fax to (859) 257-2010.
Campus (non-UK HealthCare) employees may submit to their department supervisor or designee.07/23/2013 (revision date)
Submit paper form to fax to (859) 257-2010
Email form back to email@example.com