In the event an employee needs to request a medical leave from work, qualifying KTP employees have several leave options available. Some of these medical leave options (but not all) will protect your job while you’re away and/or provide financial assistance during your leave. All medical leaves will require documentation from your doctor to be approved, and in most cases, should be requested 30 days before the date your leave will begin.
To apply for a medical leave from work, including FMLA and/or Short Term Disability, the employee leave request form should be filled out and scanned to DOCS4HR at your facility's front office copy machine. Alternatively, you can email forms to us at FMLA@kleentest.com, or leave a confidential voicemail for HR at 262-284-6600, extension 6010. The confidential HR fax number is 262-268-4789. If you choose to route this to HR through your supervisor, we encourage you to add a cover sheet to keep your personal medical information confidential.
FMLA Notice
Request Form - Medical Leave
Restricted Duty - Accommodation Request
Important Notice Regarding Obligation to Pay Benefits Premiums While on Leave
Medical Leave Case Memo - Requirements for Reporting Intermitted FMLA Absences
Request Form for Personal Leave of Absence (non-medical or not covered under FMLA/STD)
If you have other questions, click the button below to email HR.