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

4 results found available within Insurance Carrier Clear All

Employer, Insurance Carrier

Form PFL-271S - PFL Statement of Rights

Translated versions available

Learn more about Form PFL-271S - PFL Statement of Rights

Insurance Carrier

Form PFL-CR-001 - PFL Claim Denial Template

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

Employee, Employer, Insurance Carrier

Form LAC-1 - Language Access Complaint Form

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

Insurance Carrier

Notice of Compliance

Form PFL-120

Learn more about Notice of Compliance

Paid Family Leave Forms

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