Leaves of Absences
INITIAL LEAVE REQUEST
Download the Medical Leave Request Form and submit it to Human Resources via mail, email, or by dropping it off at the office. Any staff who expect to be out on leave for three or more days or who become aware of a need to take leave from time to time for a health issue should submit this form.
Human Resources will respond within five business days of receiving a Medical Leave Request Form.
- Feel free to check the California Family Rights Act, Family Medical Leave Act, and Pregnancy Discrimination Act brochures to see if you may be eligible for these types of leave.
Please note that these three types of leave are unpaid and run concurrently with accrued paid sick time during an employee’s leave.
REQUESTS FOR FMLA/CFRA AND PNL TIME:
- If you are interested in having some or all of your leave designated as California Family Rights Act (CFRA), Family Medical Leave Act (FMLA), or Pregnancy Leave (PNL) time then please participate in an interactive process with Human Resources. Human
Resources will send an FMLA Certification of Serious Health Condition Form. This form is titled “FMLA Certification” but can be used for CFRA and PNL time designation
once a medical care provider has completed it. Please take this form to a medical
care provider who can verify:
- that you or a family member has a serious medical condition or is expecting a child,
- the likely duration for treatment and recovery, and
if any work restrictions might be needed because of the condition
The FMLA Certification of Serious Health Condition Form is not needed in some situations. For example, a parent welcoming a new child should submit a birth certificate or adoption paperwork instead of the FMLA Certification of Serious Health Condition Form.
- REQUESTS FOR FMLA/CFRA AND PNL TIME: Human Resources will respond within five business days of receipt of the FMLA Certification of Serious Health Condition Form. Employees requesting FMLA/CFRA and PNL designation must continue to participate in an interactive process with human resources. This includes following up on any additional paperwork that is needed for specific types of leave and informing Human Resources and supervisors when leave is taken. Human Resources will approve or deny any related leave time as FMLA/CFRA or PNL as soon as possible.
Please contact the main Human Resources Line if you want to request a leave of absence for non-medical or personal reasons.