Leave of Absence Forms

Employee Illness ONLY - Use this form to document the illness. This form needs to be completed by the health care provider.

Family Medical Leave Act (FMLA) Form - Employee 

Family Member Illness ONLY - Use this form to document the employee's family members' illness. This form needs to be completed by the health care provider.

Family Medical Leave Act (FMLA) Form - Family Member

Use this form for certification for serious injury or illness of covered Service member for Military Family Leave.

FMLA Injury Illness Military

Use this form for certification of qualifying Exigency for Military Family Leave.

FMLA Military

This form is for leave that is less than ten full consecutive days.

Intermittent FMLA Request Form

Complete this form to apply for Paid Parental Leave.

Paid Parental Leave

Complete this form to apply for Short-Term Disability. The form may be faxed to 678-301-6111 or sent through GCPS courier to the Benefits and Leave Administration Office. This form must be completed by a health care provider.

Short Term Disability Form

Complete this form to apply for the Sick Leave Bank.

Sick Leave Bank Withdrawal Form

Use this form for spousal donation of sick leave, if your spouse is also an employee of Gwinnett County Public Schools.

Spousal Donation of Sick Leave

Leave of Absence Frequently Asked Questions.

Leave of Absence FAQ