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Certicare

How do I complete the Walmart Sedgwick certification form?

You don't fill out Sedgwick's form yourself. Answer Certicare's online questionnaire about your condition, your job duties, and what you currently can't do. A state-licensed provider reviews your answers, then completes and signs the certification Sedgwick requested, field by field.

If you already have the form Sedgwick sent, upload it during intake. If you're not sure which one applies to your case, tell us what Sedgwick asked for and we'll take it from there.

How fast can I get my Walmart Sedgwick form completed?

Usually within 24 hours after we have everything needed: your questionnaire answers and the paperwork Sedgwick sent you, if you have it. Check the due date in Sedgwick's letter or portal message — that's the deadline that matters.

If it's the middle of the night and your due date is close, start the questionnaire anyway. It's online now, and the completed form arrives by email.

Your Walmart Sedgwick form, completed and signed.

Certicare's Walmart leave paperwork service pairs your case with a state-licensed provider who completes the certification Sedgwick requested — usually within 24 hours.

Start My Intake
Completed and signed by a state-licensed provider
$49 flat, refundable any time before your form is delivered
Usually within 24 hours after we have everything needed
Sedgwick follow-up handled at no additional charge

How it works

  1. Evaluation. Answer a short online questionnaire about your condition and your Walmart leave case. No video visit required.
  2. Certification. A state-licensed provider reviews your answers and completes Sedgwick's paperwork with the functional detail it requires.
  3. Submission. Your completed form usually arrives by email in time for the due date in your Sedgwick case.
  4. Follow-up. If Sedgwick asks for more, we handle it. No additional charge.

What does Sedgwick need for my Walmart leave paperwork?

Sedgwick is the third-party administrator that handles Walmart's LOA cases, including leave that runs alongside FMLA (Family and Medical Leave Act) protections. For most LOA claims, Sedgwick wants a certification completed by a licensed provider, not a generic doctor's note or an after-visit summary.

That certification needs functional detail: your treatment and what your condition limits you from doing at work. A plain note rarely has that detail. The form Sedgwick sent you does.

Certification form

What if Sedgwick says my documentation is incomplete?

Sedgwick sometimes comes back asking for more: a missing date, a vague answer, more detail on a functional limitation. That's follow-up on your case, not a new one.

Tell us what Sedgwick is asking for. A licensed provider reviews it and completes the corrected paperwork, included in your original $49 — no separate charge, no new intake.

Follow-up, reviewed and completed — no extra charge.

What we can't do

No guarantees of approval. Walmart decides leave and accommodation requests, not Certicare.

We don't add PPTO to your account or remove attendance points directly. That's between you, PPTO, and Walmart.

No documentation without a genuine evaluation. If your case doesn't support the form Sedgwick sent, we'll tell you — not sign it anyway.

What's included in the $49 fee?

$49 flat,refundable any time before your form is delivered
Start My Intake

$49 flat, shown before you start. It covers your full Walmart Sedgwick case: the clinical review, the certification Sedgwick requested, and any follow-up Sedgwick asks for. No additional charges. If the form can't be completed, you get a refund. You can also request a full refund any time before your form is delivered, no reason required.

HIPAA-compliant

Secure online intake. Your information is reviewed by Certicare and is not sent to Walmart without your authorization.

Certicare is not affiliated with Walmart. Walmart makes the final decision on leave and accommodation requests. This page is general information about the leave process, not legal advice.

Founded by someone who's been there

Rebecca Martel, APRN, FNP-BC

Rebecca Martel, APRN, FNP-BC, is a family nurse practitioner who has completed hundreds of these forms. As a neurodivergent person who lost jobs to cyclical burnout early in her career, she knows what's at stake when paperwork stalls.

APRN, FNP-BC Licensed in New York State Board Certified in Family Health