Other Form WH-381

2025 Printable Template

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Form last updated: 03/2024. Please verify this is the current version before use.

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01

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02

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03

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How to fill out a WH-381 online?

Follow these steps to complete your WH-381 form online.

Step 01

Employers should access the form from the Department of Labor's website.

Step 02

Complete Part A to verify employee eligibility by entering relevant work details.

Step 03

Fill out Part B to inform the employee of their rights and responsibilities, including the deadline for medical certification.

Step 04

Provide the completed form to the employee and retain a copy for records.

Department of Labor - FMLA

What is a WH-381 used for?

Form WH-381 is used under the Family and Medical Leave Act (FMLA) to notify employees of their eligibility for leave and to outline their rights and responsibilities. It helps ensure employees are informed about their entitlements and the necessary steps when requesting leave for family or medical reasons.

Who needs to fill out a WH-381 form

Employers must provide this form to employees who request FMLA leave to inform them of their eligibility and rights.

What information does Form WH-381 provide?

It details eligibility for FMLA leave, employee rights, and responsibilities, along with employer obligations.

How long does an employee have to complete the medical certification?

Employees generally have 15 calendar days to complete and return the medical certification after the employer requests it.

What if I am a key employee?

Key employees may face different reinstatement rules under FMLA, particularly if their absence would cause significant economic harm to the employer.

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