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Union Pacific Railroad - Health & Medical Department fax number

(402) 233-3305

Health & Medical Department

Used for: FMLA medical certification submission (Certification of Health Care Provider)

Fax destination details

Department
Health & Medical Department
Purpose
FMLA medical certification submission (Certification of Health Care Provider)
Form
16874 — Certification of Health Care Provider (Family and Medical Leave Act)
Address
1400 Douglas St, Stop 0350, Omaha, NE 68179

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Instructions for completing the FMLA medical certification; the form requires the health care provider to certify the employee's or family member's health condition, treatment, and return-to-work information.

Review official form instructions

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