Create Form Wh 380 E

Form Wh 380 E: What Is It?

This form is used by the United States Department of Labor, Wages and Hour Division. A Form WH 380-E is known as a Certification of Health Care Provider for Employee’s Serious Health Condition. This form will be used to verify the medical condition of an employee. Three parties will need to fill out different sections of the form: the employer, the employee, and the health care provider.

The employer will be the first person to fill out the form. They will need to include their own information, as well as information about the employee. That includes their job title and their work schedule. Next, the employee needs to list their full name. The last section is completed by a health care professional. This section will detail the serious health condition. The medical professional will need to include documentation of the illness so that the employee’s leave can be approved.