Requesting a Leave of Absence

Employee Self Service

Use remote access to log in to Employee Self Service and review and/or change your benefits information.


We recognize that employees may find it necessary to take leave from their jobs for a temporary period to address certain family responsibilities or for their own serious health conditions.


 To request a Leave of Absence, please take the following steps:

  • Notify your immediate supervisor of your leave request;
  • Visit the Leave of Absence Inquiry in the Team Member Solutions Center to Access the desired form.
  • Complete the employee section of the form;
  • If you are applying for FMLA or Other Medical Leave of Absence, submit the certification form to your doctor (or family member’s doctor, if applicable) to complete;
  • Send completed forms to the NHRMC Benefits Team by faxing to 910.815.5969 or emailing to

Returning to Work

If you are returning to work following a leave of absence related to your own medical condition, follow the instructions outlined in the Return to Work Process.
If you are returning to work following a leave of absence for any other reason, coordinate your return to work with your manager and the HR Benefits Team.