Forms

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

9 results found available within Employee Clear All

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

Employee

PFL-Bonding Leave Form

Paid Family Leave Request - Bond with a Newborn, a Newly Adopted or Foster Child

Forms PFL-1 and PFL-2

Learn more about PFL-Bonding Leave Form

Employee

PFL- Family Care Leave Form

Paid Family Leave Request - Care for a Family Member with Serious Health Condition

Forms PFL-1, PFL-3, PFL-4

Learn more about PFL- Family Care Leave Form

Heart with a star and two lines to represent a flag in the middle

Employee

PFL- Military-Related Leave Form

Paid Family Leave Request - Assist Families in Connection with a Military Deployment

Forms PFL-1 & PFL-5

Learn more about PFL- Military-Related Leave Form

Employee, Employer

PFL-Waiver Form

Form PFL-Waiver - Employee Paid Family Leave Opt-Out and Waiver of Benefits

Learn more about PFL-Waiver Form

Employee, Discrimination

PFL-DC-119 Form

Form PFL-DC-119 - Formal Request for Reinstatement Regarding Paid Family Leave

Learn more about PFL-DC-119 Form

Employee, Discrimination

PFL-DC-120 Form

Form PFL-DC-120 - Paid Family Leave Discrimination/Retaliation Complaint

Learn more about PFL-DC-120 Form

Employee, Employer, Insurance Carrier

LAC-1 Form

Form LAC-1 - Language Access Comment Form

Learn more about LAC-1 Form