Mashantucket Pequot Family and Medical Leave Law Forms
(Excludes Military-Specific Forms)
- Notice of Eligibility and Rights & Responsibilities
- Designation Notice
- Verification of Relationship
- Certification of Health Care Provider for Employee's Serious Health Condition
- Certification of Health Care Provider for Employee Organ or Bone Marrow Donation
- Certification of Health Care Provider for Family Member's Serious Health Condition
Important Notice:
An individual who wishes to file a claim under the MFML Law must file the claim within 180 calendar days of the event believed to be a violation of the law. Please review carefully the specifics of the law and case filing procedures that may be found on this website or contact the MERO for additional information.
