California Hydronics Corporation (CHC)

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Step 1: Read About Your Leave

Family Medical Leave Act (all offices)

 The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.  

California Family Rights Act (CA)

 The CRFA authorizes eligible employees to take up a total of 12 weeks of paid or unpaid job-protected leave during 12 months. To care for an immediate family member (spouse, child, or parent) and designated persons, such as an aunt, uncle, or cousin with a serious health condition.   Please review other types of relationships it covers.

California Pregnancy Disability Leave (CA)

California State Disability Insurance and Paid Family Leave (CA)

The PDL allows a woman to take leave while she is disabled by her pregnancy or childbirth. An employee who has a disability related to her pregnancy or the birth of her child can receive up to four months of maternity leave while that disability continues. 

California State Disability Insurance and Paid Family Leave (CA)

California State Disability Insurance and Paid Family Leave (CA)

 SDI and  PFL provide wage replacement benefits to eligible workers who need time off from work.  




Washington State's Paid Family & Medical Leave

 WPFML is a new benefit for Washington workers and lets you take up to 12 weeks of paid time off when you need it most.  

Personal Leave

A personal leave of absence is an absence from work taken for personal reasons not otherwise covered by the FMLA or other protected leave policies and not typically used to extend an existing leave. Personal leaves of absence are unpaid and are not job-protected. 

Step 2: Complete the Staff Leave Request Form

Staff Leave Request Form (pdf)Download

Step 3: Forms & Pamphlets

California Employees

Please complete the Certification of Healthcare Provider for yourself or your family member and email a copy to HR. 


If you are applying for FMLA/CFRA or PFL for yourself and PDL, please read the

  Disability Insurance Provisions Pamphlet and Disability Claim Form

  Paid Family Leave


Washington, Nevada, Arizona, and Alaska Employees

 Certification of Healthcare Provider for a Serious Health Condition

**Please select and email HR a copy


  • Employee’s Serious Health Condition –  for the medical condition of an employee. 
  • Family Member’s Serious Health Condition – for the medical condition of the employee’s family member.


Certification of Military Family Leave

**Please select and email HR a copy

  • Qualifying Exigency – for leave request that arises out of the foreign deployment of the employee’s spouse, son, daughter, or parent.
  • Military Caregiver Leave of a Current Servicemember – for requesting leave to care for a family member who is a current service member with a serious injury or illness.
  • Military Caregiver Leave of a Veteran–  when requesting leave to care for a family member, a covered veteran with a serious injury or illness.


Washington's Paid Family Leave for more information and how to file a claim.


Step 4: Pause 401(k) & Flex Spending Contributions

Flex Spending & Dependent Care Leave Form (pdf)Download
401 K Leave of Absence Request Form (pdf)Download

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