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  • Request for Family and Medical Leave
  • Click to view form (pdf or doc) »
  • UK HealthCare employees should submit the form to the UK HealthCare FMLA administrator at whitney.cunningham@uky.edu or fax to 859-257-2010. Campus (non-UK HealthCare) employees should submit the form to the Campus FMLA Administrator at lindseyhpowell@uky.edu or fax to 859-257-1679.
  • Revision date: 11/03/2017
  • Submit paper form to UK HealthCare fax to 859-257-2010 or Campus fax to 859-257-1679