Human Resources


​Family Medical Leave

Information and Tools for FMLA

FMLA Leave Application Process

Step 1: Click here to review Administrative Directive AD3-72.

Step 2: Download the FMLA in English or Spanish and follow the instructions. *

Click here for English
Click here for Spanish.

*We highly recommend you meet with an FMLA coordinator before you complete the application, so we may guide you through the process. However, this is not required.

Step 3: Submit the completed forms to your FMLA coordinator. Options for submitting your forms are listed below. 

Click here for a list of coordinators. Please contact your coordinator before submitting any forms.

  • Option 1: Deliver the originals to City Hall, Room 6AN
  • Option 2: Mail the original forms to City of Dallas Human Resources, 1500 Marilla, 6AN, Dallas, TX 75201
  • Option 3: For doctor's office only: Forms may be faxed to 214-670-0729 or emailed to
    laura.campos-martine@dallascityhall.com
  • Option 4: Delivery by a third party or interoffice mail to City Hall, Room 6AN. *Forms must be in a sealed envelope to be accepted.

Reminders

  • All medical information is protected under HIPPA/PHI for you and your family members.
  • When out on FMLA, it is the responsibility of the employee to accurately record their leave usage and track their remaining balances.
  • Follow department call-in procedures during block and intermittent leave.
  • If you need to return from FMLA prior to approved dates, contact your FMLA coordinator.
  • When you are on FMLA leave, you are not allowed to work from home.
  • Click here for other Frequently Asked Questions.
  • While you are on FMLA leave, your health insurance will continue on the same terms as if you had continued to work.
  •  Payroll deductions for benefits will continue while you are on paid leave. If you are in leave without pay status, you will be required to pay your share of health benefits directly to HR Benefits. For more information, contact your coordinator or HR Benefits at 214-671-6947, Option 1.