Request Family Medical Leave

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

Posted: September 9th, 2018 1:02 PM

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

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