Request Family Medical Leave

Download
Family Medical Leave Request
Download
Family Medical Leave Time Reporting Form
Download
Family Medical Leave Medical Verification Form

Employee should complete this leave request, and then forward with appropriate medical or other verification along with a Family Medical Leave Time Reporting Form to the Disability Benefits Coordinator:

Mary Baptiste
Phone: 510-238-2270
Email: mbaptiste@oaklandca.gov

Posted: September 9th, 2018 1:02 PM

Last Updated: January 20th, 2021 7:53 PM

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