UK FMLA Request for Information

Please fill out this form to initiate the process of applying for FMLA (Family Medical Leave) at UK.

First Name

Middle Name

Last Name

UK Department

Preferred Contact Method

Email Address

Phone Number

Reason for Request

Supervisor Name

Supervisor Email

Main Office
106 Bosworth Hall
631 S. Limestone
Lexington, KY 40506-0652
Phone: (859) 257-9555
Fax: (859) 323-8512
hr@uky.edu