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Did you request leave for any of the following reasons:

(1) for the birth and care of the newborn child of the employee;

(2) for placement with the employee of a son or daughter for adoption or foster care;

(3) to care for an immediate family member (spouse, child, or parent) with a serious health condition; or

(4) to take medical leave when the employee is unable to work because of a serious health condition.

 

Yes. I asked for leave based on one or more of the reasons listed above

No. I wanted to take leave for other reasons

FMLA CASE SCREENER