CLARIFICATION NEEDED FOR YOUR NEW LEAVE OF ABSENCE- NextLevelUrgentCareTexas.us;Whole Foods Market Leave Service Center Doctor’s Sick Notes and Health Care Forms Filled, Stamped and Signed Online
Phone:1234567678 | Web: www.nextlevelurgentcaretexas.us | Fax: 1233445566 | PO Box 14192 Lexington, KY 40512
August 6, 2026
Dear Client Thomas,
Whole Foods Market Leave Service Center is here to help you with your time away from work. Our goal is to make this process as simple as possible for you.
You submitted medical documentation, however; the documentation did not include all the information needed to make a determination on your claim.
- Your Case Number: 1233445567
- Your Time Away Begins: July 20, 2026
- The Reason For Your Leave: your own serious health condition
- Clarification Due Date: August 26, 2026
Here’s What You Need to Do:
☐ Information Needed: Have your health care provider update the Health care Provider Certification Form, initial and date any changes, and then return to Whole Foods Market Leave Service Center. If the requested information is not provided, your request for leave may be denied. A denial may result in changes to your employment status. You are responsible for any fees the health care provider may charge for medical documentation.
☐ Clarification Required: Health care provider certification form needed.
☐ Comments: The doctor’s note received is insufficient. Please have the provider complete and sign the health care provider certification form.
How to Return Your Documents:
Upload: here | Email: tyyiiooo Fax: 1234455
Eligibility for Leave of Absence
If your first day of absence is in the future, we will review your eligibility again at the start of your leave.
- The Family and Medical Leave Act (FMLA) provides job-protected time off to eligible employees. You do not meet the FMLA’s basic eligibility requirements because you do not meet the FMLA’s 12-month length of service requirement. On the first date of your requested leave, you will have worked approximately 1 months.
- The Family and Medical Leave Act (FMLA) provides job-protected time off to eligible employees. You do not meet the FMLA’s basic eligibility requirements because you have not met the FMLA’s 1250-hours worked requirement. On the first date of your requested leave, you will have worked approximately 49.00 hours.
- You are eligible for leave under the Medical Emergency Leave. Typically, approved company leaves run concurrently with any approved FMLA or State leave.
Reasonable Accommodations
Whole Foods Market is committed to providing reasonable accommodations is committed to providing reasonable accommodations, pursuant to applicable law (including, but not limited to, the Americans with Disabilities Act, the Pregnant Workers’ Fairness Act, and Section 503 of the Rehabilitation Act of 1973)
If you have a health condition that impacts your ability to do your job, you may be eligible for a reasonable accommodation to help you perform the essential functions of your job (e.g. on-the-job accommodation or leave as accommodation). Accommodation examples may include, but are not limited to, assistive devices, ergonomic equipment, schedule adjustment, modified duty, a temporary reduced work schedule, transitional alternate job assignments, leave of absence, or reassignment. Additional information is available at our website online
Sedgwick will initiate an ADA Accommodation claim on your behalf. The Whole Foods Market Leave Service Center will contact you.
