Fill Out DOL Form WH-382 Online
Designation Notice (FMLA)
U.S. Department of Labor
Informs an employee whether their requested leave is designated as FMLA leave.
Reviewed July 2026
How it works
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Open the form. The official PDF loads straight into the editor, no download needed first.
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Fill it out in the editor. Click anywhere to type, add checkmarks and place your signature.
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Download your PDF. Save the completed form, ready to print or submit.
Form WH-382, the FMLA Designation Notice, is the Department of Labor's model form employers use to tell an employee whether their requested leave is designated as FMLA leave. It closes the loop that starts with the eligibility notice and any medical certification.
You can complete the WH-382 in the Universal PDF editor, mark the designation decision and any conditions such as a fitness-for-duty certificate, and download the finished PDF for delivery to the employee.
What is Form WH-382 used for
After an employer has enough information to decide whether a leave qualifies under the FMLA, it must tell the employee the outcome. The WH-382 records one of three results: the leave is designated as FMLA leave, more information is needed, or the leave is not designated because it does not qualify or the entitlement is exhausted.
The form also covers practical conditions: how much leave will be counted against the employee's FMLA entitlement, whether paid leave will be substituted, and whether the employee must provide a fitness-for-duty certification before returning to work.
Who files Form WH-382
The employer completes the WH-382 and delivers it to the employee. Use of the DOL model form is optional, but the designation notice itself is a regulatory requirement for covered employers, and it is retained in the employer's FMLA records rather than filed with any agency.
How to fill out Form WH-382
The form walks through the decision in order:
- Check whether the leave is approved and designated as FMLA leave.
- If the certification was incomplete, specify what additional information is needed and the deadline to provide it.
- State the amount of leave that will be counted against the FMLA entitlement, if known.
- Indicate whether paid leave will run concurrently and whether a fitness-for-duty certification is required for reinstatement.
Deadlines and retention rules
The employer must provide the designation notice within five business days of having enough information to determine whether the leave is FMLA-qualifying, absent extenuating circumstances. If the amount of leave counted changes, the employer updates the employee accordingly.
A fitness-for-duty requirement must be stated in the designation notice for the employer to enforce it at reinstatement. Copies stay in the employer's FMLA file for at least three years.
Frequently asked questions
Within five business days of the employer having enough information to determine whether the leave qualifies under the FMLA, absent extenuating circumstances.
Yes. The form includes options for leave that does not qualify or when the employee has exhausted the FMLA entitlement, and the employer marks the applicable reason.
A statement from the employee's health care provider that the employee can resume work. An employer can require it after leave for the employee's own serious health condition, but only if the requirement was stated in the designation notice.
No. The employer delivers it to the employee and keeps a copy in its FMLA records.
Generally yes. Under DOL guidance, once leave qualifies, the employer designates it as FMLA leave and counts it against the entitlement; employees cannot decline designation of qualifying leave.
Related forms
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