Related Information
USM Parental Leave Policy (Faculty)
USM Parental Leave Policy (Staff)
UBalt Staff & Faculty Pregnacy Accomodation Request Form
Family and medical leave is a valuable benefit that allows employees to take care of important family and health situations without putting their jobs at risk. Following the requirements of the Family and Medical Leave Act (FMLA) of 1993 ensures that the University of Baltimore is in compliance with USM policy as well as state and federal requirements. Please review the FMLA Job Aid for additional details and contact the Employee Relations and Leave Specialist in the Office of Human Resources prior to completing any of the paperwork.
FMLA Policy for Faculty
FMLA Policy for Staff
What is the process?
Step 1:
- Contact Nicole Butler, Employee Relations and Leave Specialist, in the Office of Human Resources (OHR)
- Complete the Employee Request for Family and Medical Leave
- Have your supervisor and department head sign the form
- Submit the form to Nicole Butler in OHR*
Step 2:
- Have your physician complete one of the below FMLA forms:
Certification of Health Care Provider for Employee's Serious Health Condition
Certification of Health Care Provider for Family Member's Serious Health Condition
Certification of Serious Injury or Illness of Covered Servicemember - For Military Family Leave *This form is completed by Current Servicemember
- Fax the completed form to Nicole Bulter at 410.837.5408 (confidential)
Step 3:
- When you are ready to return to work (including work from home or another location), have your physician complete the Return to Work Medical Certification Form
- If you are released to work less than normal hours, a certification must be provided each time there is a change to the number of authorized work hours as well as other restrictions
- Submit completed form to Nicole Butler in OHR*
*Choose One of the Following to Submit Forms:
- Secure confidential FMLA Document Upload Portal
- Email to nbutler2@ubalt.edu
- Fax to 410-837-5408