Step 1: Read About Your Leave
Family Medical Leave Act (all offices)
California Pregnancy Disability Leave (CA)
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)
California Pregnancy Disability Leave (CA)
Family Medical Leave Act (all offices)
The CRFA authorizes eligible employees to take up a total of 12 weeks of paid or unpaid job-protected leave during a 12-month period. To care for an immediate family member (spouse, child, or parent) with a serious health condition.
California Pregnancy Disability Leave (CA)
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)
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
California State Disability Insurance and Paid Family Leave (CA)
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
California State Disability Insurance and Paid Family Leave (CA)
Washington State's Paid Family & Medical 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 3: Forms & Pamphlets
California Employees
Certification of Healthcare Provider for a Serious Health Condition
**Please select and email HR a copy
If you are applying for FMLA/CFRA or PFL for yourself and PDL, please read the
Disability Insurance Provisions Pamphlet and Disability Claim Form
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, form WH-380-E – use when a leave request is due to the medical condition of the employee.
- Family member’s serious health condition, form WH-380-F – use when a leave request is due to the medical condition of the employee’s family member.
Certification of Military Family Leave
**Please select and email HR a copy
- Qualifying Exigency, form WH-384 – use when the leave request arises out of the foreign deployment of the employee’s spouse, son, daughter, or parent.
- Military Caregiver Leave of a Current Servicemember, form WH-385 – use when 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, form WH-385-V – use when requesting leave to care for a family member is who a covered veteran with a serious injury or illness.
Washington's Paid Family Leave for more information and how to file a claim.