Leave of Absence

Pregnancy Disability Leave:

• Pregnancy Leave Checklist
• PT 384 - Pregnancy Disability Leave Policy
• PT 400 - Employee Request for Leave
• PT 381 - Certification for Pregnancy Disability Leave
• Form DE 2515-DI Provisions Brochure (Oct 2023)
• PT 383 - Medical/Family Leave Policy (Baby Bonding) (January 2021)
• PT 400 - Employee Request for Leave
• Form DE 2511- Paid Family Leave Brochure (Oct 2023)
• Benefits Continuation Letter - Sample
• Form DE 2589 (Oct 2023)

Medical/Family Leave (Self):

• Medical Leave Checklist
• PT 383 - Medical/Family Leave Policy (January 2021)
• PT 400 - Employee Request for Leave
• PT 380 - Medical Certification Form for Employee
• Form DE 2515-DI Provisions Brochure (Oct 2023)
• Benefits Continuation Letter - Sample
• Form DE 2589 (Oct 2023)

Medical/Family Leave (care for another):

• Checklist (Care for Another)
• PT 383 - Medical/Family Leave Policy (January 2021)
• PT 400 - Employee Request for Leave
• PT 380F - Medical Certification Form for Family Member
• Form DE 2511- Paid Family Leave Brochure (Oct 2023)
• Benefits Continuation Letter - Sample
• Form DE 2589 (Oct 2023)

Ineligible Employee Leave:

• Checklist (Ineligible Employee Leave)
• PT 388 - Unpaid Family Leave Policy for Employees Not Eligible for Medical/Family Leave (January 2021)
• PT 400 - Employee Request for Leave
• PT 380 - Medical Certification Form for Employee
• PT 380F - Medical Certification Form for Family Member
• Form DE 2515-DI Provisions Brochure (Oct 2023)
• Form DE 2511- Paid Family Leave Brochure (Oct 2023)
• Benefits Continuation Letter - Sample
• Form DE 2589 (Oct 2023)

Click here to see a complete list of all Lay Personnel Policies and Forms.