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

21 results found

Employer Resources, Employer Resources

2022 PFL Payroll Deduction Notice

Notice to Employees

Download about 2022 PFL Payroll Deduction Notice

Employer Resources, Employer Resources

PFL Model Language for Employee Materials

For handbooks or written guidance

Download about PFL Model Language for Employee Materials

Employer, Insurance Carrier

PFL Statement of Rights

Form PFL-271S

Download about PFL Statement of Rights

COVID-19, Employee

Request for COVID-19 Quarantine PFL - Child

Forms PFL-1 and CCOVID19

Download about Request for COVID-19 Quarantine PFL - Child

COVID-19, Employee

Request for COVID-19 Quarantine DB/PFL - Self

Forms PFL-1 and SCOVID19

Download about Request for COVID-19 Quarantine DB/PFL - Self

Health Care Provider

PFL Poster Order Form

To request PFL Poster

Download about PFL Poster Order Form

Employee, Employer, Insurance Carrier

Language Access Complaint Form

Form LAC-1

Download about Language Access Complaint Form

Employee, Discrimination

Request for Reinstatement

Form PFL-DC-119

Download about Request for Reinstatement

Employee, Employer

PFL Waiver Form

Employee Opt-Out and Waiver of Benefits

Download about PFL Waiver Form

Employer, Discrimination

Employer's Response to PFL Discrimination Complaint

Form PFL-DC-130

Download about Employer's Response to PFL Discrimination Complaint

Paid Family Leave Forms

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