Employee Leaves

There are various types of available paid and unpaid leaves of absence such as personal, military, maternity, parental and family leaves. Staff covered by a collective bargaining agreement should refer to their contract. Leaves are intended for employees with extenuating circumstances that require time away from work of more than five (5) days in most circumstances for a specified purpose and an agreed upon period of time.

Employee Rights and Responsibilities under the Family Medical Leave Act

Steps to request a leave of absence at NSMC:

Employees must complete the Leave of Absence Request Form, sign it and obtain their manager's signature. Completed, signed forms are then sent to:

Leave Coordinator
NSMC Human Resources
81 Highland Ave
Salem, MA 01970

Fax: 978.740.4817

Health Care Provider Certification Forms

Employees must have their treating healthcare provider complete and sign one of the following Certification Forms. They are then asked to submit the completed form to the NSMC Occupational Health Department within 15 days of the request for Leave of Absence.

Military Family Forms:

Health Care Provider Certification Forms:

Voluntary Short-Term Disability 

If you have elected Voluntary Short-Term Disability from Unum and would like to begin a claim, you must contact Unum directly at 1.877.217.5491. See brochure for more information.

You must use your Earned Time during your elected waiting period for any type of leave.


Phone: 978.825.6294                        E-mail: NSMCHRQuestions@partners.org