Page:United States Statutes at Large Volume 110 Part 6.djvu/537

 CONCURRENT RESOLUTIONS—APR. 16, 1996 110 STAT. 4359 State means any State of the United States or the District of Columbia or any Territory or possession of the United States. Teacher (or employee employed in an instructional capacity, or instructional employee) means an employee employed principally in an instructional capacity by an educational agency or school whose principal function is to teach and instruct students in a class, a small group, or an individual setting, and includes athletic coaches, driving instructors, and special education assistants such as signers for the hearing impaired. The term does not include teacher assistants or aides who do not have as their principal function actual teaching or instructing, nor auxiliary personnel such as counselors, psychologists, curriculum specialists, cafeteria workers, maintenance workers, bus drivers, or other primarily noninstructional employees. APPENDIX A TO PART 825—[RESERVED] APPENDK B TO PART 825—CERTIFICATION OF PHYSICIAN OR PRACTITIONER CERTIFICATION OF HEALTH CARE PROVIDER (FAMILY AND MEDICAL LEAVE ACT OF 1993 AS MADE APPLICABLE BY THE CONGRESSIONAL ACCOUNTABILITY ACT OF 1995) 1. Employee's Name: 2. Patient's Name (if different from employee): 3. The attached sheet describes what is meant by a "serious health condition" under the Family and Medical Leave Act as made applicable by the Congressional Accountability Act. Does the patient's condition ^ qualify under any of the categories described? If so, please check the applicable category. (1) (2) (3) (4) (5) (6) ,or None of the above 4. Describe the medical facts which support your certification, including a brief statement as to how the medical facts meet the criteria of one of these categories: 5.a. State the approximate date the condition commenced, and the probable duration of the condition (and also the probable duration of the patient's present incapacity ^ if different): b. Will it be necessary for the employee to take work only intermittently or to work on a less than full schedule as a result of the condition (including for treatment described in Item 6 below)? If yes, give probable duration: c. If the condition is a chronic condition (condition #4) or pregnancy, state whether the patient is presently incapacitated ^ and the likely duration and frequency of episodes of incapacity 2; 6.a. If additional treatments will be required for the condition, provide an estimate of the probable number of such treatments: If the patient will be absent from work or other daily activities because of treatment on an intermittent or part-time basis, also provide an estimate of the probable number and interval between such treatments, actual or estimated dates of treatment if known, and period required for recovery if any: b. If any of these treatments will be provided by another provider of health services (e.g., physical therapist), please state the nature of the treatments:

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