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LITTLE ROCK
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Human Resources
Medical Leave Reference Center
LRSD Medical Leave of Absence Packets and Information
Name
Type
Size
Name:
Request for Medical Leave Form (Required)
Type:
pdf
Size:
350 KB
Name:
Employee's Serious Health Condition form
Type:
pdf
Size:
1.24 MB
Name:
Family Member's Serious Health Condition form
Type:
pdf
Size:
580 KB
Name:
Medical Leave Update form
Type:
pdf
Size:
460 KB
Name:
Return to Work Certification form
Type:
pdf
Size:
709 KB
Name:
Military Family Leave for Qualifying Exigency form
Type:
pdf
Size:
258 KB
Name:
Military Leave of a Current Servicemember form
Type:
pdf
Size:
321 KB
Name:
Military Caregiver Leave of a Veteran form
Type:
pdf
Size:
383 KB
Name:
Short Term Disability Claim form
Type:
pdf
Size:
559 KB
Name:
Long Term Disability Claim form
Type:
pdf
Size:
856 KB
Name:
Hospital Confinement form
Type:
pdf
Size:
254 KB
Name:
Employee Request for Military Leave
Type:
pdf
Size:
694 KB
Name:
ADA Reasonable Accommodation Request form
Type:
pdf
Size:
706 KB