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Protected Leaves

​Need a leave of absence?

Requesting a leave of absence is a quick and easy process. Follow the steps below.


To request leave, start here:


1.)    Find out if you are eligible

Visit the FAQs page to find out eligibility requirements and other important information to know before you begin.

2.)    Complete FML/Medical Leave Request Form

3.)    Take the appropriate Health Certification Form to your provider

Most providers don't fill out paperwork on demand. This could take several days for completion.

If an employee has medical insurance through Kaiser Permanente, the process in obtaining Health Certification forms is requested electronically. Click here for a detailed explanation of the Kaiser Permanente FML + PFML Application Process. 

Select what the leave is for...

Other circumstances: Email kitsapbenefits@kitsap.gov

4.)    Submit Certification Form & FML/Medical Leave Request Form to HR

Once your provider has returned the completed certification form, submit both completed FML/Medical Leave Request form and Certification of Health to HR. 

Email: kitsapbenefits@kitsap.gov (this is a confidential inbox)

Fax: 360.337.7187 

OR mail: 

614 Division Street, MS - 23A, 

Port Orchard, WA 98366-4676

5.)    HR Reviews the application and provides a designation

Based on the documents provided in accordance to FML regulations, HR will approve the request, deny it, or ask for more information. If approved, communication will be sent to the employee, their supervisor, and timekeeper, outlining the basic information of the leave. The ability to code time as FML will be opened in Workday at this time. 


When it's time to return to work:


When it's your own health reasons, print the following and take them to your provider:

Physical requirements of your job

Click here to find the physical requirements of your job. Take this, along with the Fitness for Duty form below to your provider. Your provider uses your physical requirements to accurately assess the physical demands of your job and consult on time needed for recovery.

Used for any personal at home injury or extended personal medical absence. Check with an HR Benefits Specialist to see if this applies to you. 

CDL Drivers
If an employee has been out due to personal health reason, they are required to submit a DOT Medical Certification with their Fitness for Duty Certification. 

When it's caring for a family member: Notify your department 

Need assistance?
If you have questions, issues, or need a paper copy of the required forms, please email kitsapbenefits@kitsap.gov




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