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Medical Leaves & Disability
Questions?
Contact Wayne County Disability Administrator at 313-224-5107 or email to disability@waynecountymi.gov. Disability Administration fax number is 313-967-1243.
Leave of Absence Information
Healthcare Provider Forms
NOTE: It is important that the department personnel officer is immediately made aware of any leave in order to comply with Federal notice regulations under the Family Medical Leave Act.
- Family Medical Leave Act(rev 2023)
- Employee - Certification of Health Care Provider
- Family Member - Certification of Health Care Provider
- Military Family - Certification of Qualifying Exigency
- Injured Service Member
- Leave of Absence Request Form
- Return From Leave Notice
- Eligibility and Rights #26 Responsibilities
- Authorization to Release Health Care Information
