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Matrix Absence Management, Inc. fax number

(877) 788-9736

FMLA/Leave of Absence Administration

Used for: Submit medical certification form from the health care provider to Matrix Absence Management to initiate/maintain FMLA/medical leave processing.

Fax destination details

Department
FMLA/Leave of Absence Administration
Purpose
Submit medical certification form from the health care provider to Matrix Absence Management to initiate/maintain FMLA/medical leave processing.
Form
FMLA medical certification form — FMLA medical certification form (medical certification for leave of absence)
Voice phone
877-202-0055

Before you send

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  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Provide a completed medical certification form from the health care provider to Matrix Absence Management as part of the leave filing process.

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