Employee signs and provides to their physician to authorize the release of medical information.  It is provided to the employee with other FMLA/CFRA forms. 

Spanish version - This form is completed by the employee's physician; it provides relevant medical information to certify the need for FMLA/CFRA leave.

Spanish version - Employer provides this FMLA/CFRA fact sheet to Spanish-speaking employees to notify them of their FMLA/CFRA rights.

Employer provides this Notice to an employee to designate their FMLA/CFRA leave, within five days from knowledge of the need for leave.

Employer provides this Notice to employees when FMLA/CFRA is requested.

Employer Checklist for FMLA CFRA Medical Leaves (Form 4500)

Employer uses this checklist to guide them on all steps during the FMLA/CFRA leave for Parent's baby bonding.  It includes links to forms and documents.

Employer uses this letter when FMLA/CFRA is about to expire and the employee has not requested an extension of their leave, and Employer is expected them to return when previously expected.

Employers uses this letter to designate an extended FMLA/CFRA leave, in response to an employee who has submitted a Medical Certification requesting additional FMLA/CFRA time for themselves or to care for a family member.

Employer uses this letter for an employee who may need additional FMLA/CFRA time off.

Employer uses this letter for an Employee who is caring for a family member and may need additional FMLA/CFRA time off.

Employer uses this letter when an Employee is caring for a family member and FMLA/CFRA will soon expire, but they are requesting additional time off, and Employer is granting the request.

Employer uses this letter when FMLA/CFRA is about to or has expired and the Employee has requested additional time off.

Employer provides this form to an Employee to request an FMLA/CFRA leave of absence. 

Employer provides this form to an employee as part of their FMLA/CFRA paperwork, for the Employee to give to their physician to complete.  It provides certification of the need for FMLA/CFRA leave.

Employer uses this letter if additional information is needed to be able to designate an FMLA/CFRA leave.

Employer uses this letter in response to a personal leave request, in order to approve the leave and provide details on pay and benefits during leave.

This form may be used to certify that an employee is able to return to work.  It is completed by the Employee's physician.