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 the California Fair Employment and Housing Commission. 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 in the process of being updated to reflect the Fair Employment and Housing Council's renumbering of pertinent sections of the California Code of Regulations, which now appear at title 2, sections 11000 - 11141.