Paid Family Leave Forms

Forms

Assistance with Forms

If you have difficulty in obtaining the Paid Family Leave forms or need help in completing these forms, please contact the PFL Helpline at (844)-337-6303.

All Paid Family Leave Forms

24 results found

Employer Resources, Employer Resources

PFL Resources for Small Businesses

Learn more about PFL Resources for Small Businesses

Discrimination

Form PFL-32-D - Section 32 Waiver Agreement

Learn more about Form PFL-32-D - Section 32 Waiver Agreement

Employer, Discrimination

Form PFL-300.5-D - Stipulation for PFL Discrimination Claim

Learn more about Form PFL-300.5-D - Stipulation for PFL Discrimination Claim

Employee

Form PFL-820.1 - Supplement to Certificate of Insurance

Learn more about Form PFL-820.1 - Supplement to Certificate of Insurance

Insurance Carrier

Form PFL-CR-001 - PFL Claim Denial Template

Learn more about Form PFL-CR-001 - PFL Claim Denial Template

Employer, Discrimination

Form PFL-DC-130 - Employer's Response to PFL Discrimination Compl...

Learn more about Form PFL-DC-130 - Employer's Response to PFL Discrimination Complaint

Employee, Employer, Insurance Carrier

Form LAC-1 - Language Access Complaint Form

Learn more about Form LAC-1 - Language Access Complaint Form

COVID-19, Employee

Forms PFL-1 and SCOVID19 - Request for COVID-19 Quarantine DB/PFL...

Learn more about Forms PFL-1 and SCOVID19 - Request for COVID-19 Quarantine DB/PFL - Self

COVID-19, Employee

Forms PFL-1 and CCOVID19 - Request for COVID-19 Quarantine PFL - ...

Learn more about Forms PFL-1 and CCOVID19 - Request for COVID-19 Quarantine PFL - Child

Employer Resources, Employer Resources

PFL Model Language for Employee Materials (2023)

Learn more about PFL Model Language for Employee Materials (2023)

Paid Family Leave Forms

SHARE

Translation Services