Certification of Healthcare Provider for Family Member's Serious Health Condition (CA)

A California-compliant medical certification form under the California Family Rights Act (CFRA) for certifying the serious health condition of an employee's family member, such as a spouse, child or parent. This Standard Document is adapted from the prototype provided by California's Department of Fair Employment and Housing. Integrated notes with important explanations and drafting tips have been added. This Standard Document is based on California law. For information on federal and other states' leave law requirements, see the Family and Medical Leave Act (FMLA) resources and State Q&A Tools under Related Content.

This resource is being updated to reflect the newly revised CFRA regulations taking effect July 1, 2015 (see Legal Update, California Family Rights Act's New Regulations Become Effective July 1 ).

Practical Law Labor & Employment


The full text of this resource is available by logging in or by requesting a trial. If you have any questions, please contact us or your Practical Law Account Executive.

Free trial

A free trial will give you:

Unlimited access to our online legal know-how services during the trial period
Full training and support
Four issues of Practical Law The Journal, the companion to Practical Law online
Weekly update e-mails on current legal developments in your practice area

Log in using Practical Law username

Only use this login if you have not set up OnePass for Practical Law

{ "siteName" : "PLC", "objType" : "PLC_Doc_C", "objID" : "1247503549366", "objName" : "ACT_OWNED - READ_ONLY - 2-506-9535", "userID" : "2", "objUrl" : "http://us.practicallaw.com/cs/Satellite/us/resource/2-506-9535?source=relatedcontent", "pageType" : "Resource", "academicUserID" : "", "contentAccessed" : "false", "analyticsPermCookie" : "269160404:15a83428b14:-ac7", "analyticsSessionCookie" : "269160404:15a83428b14:-ac6", "statisticSensorPath" : "http://analytics.practicallaw.com/sensor/statistic" }