Paid Family Leave Forms

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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

23 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

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