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Request for Military Family Leave Form

  • Request for Military Family Leave Form
  • Click to view (pdf or doc)
  • Request for Family and Medical Leave - Serious injury or illness of current servicemember for Military Family Leave
  • Revision date: 07/23/2013
  • Submit paper form to Fax to 859-257-2010 (UK HealthCare employees) or 859-257-1679 (campus employees)
  • Email form back to LeaveAdminFMLA@uky.edu