Request for Benefits Provided Under the Families First Coronavirus Relief Act
To request benefits that are provided under the Families First Coronavirus Response Act (FFCRA):
- You must complete the FFCRA Benefit Request Form.
- Read the entire form.
- Complete this form and submit to human resources.
- Send requested documentation in with the form, if possible. You will receive an email back once your leave request has been approved or denied.
- If your leave is going to be over 10 consecutive work days, you must follow the process to request a Leave of Absence
NOTE: Human Resources may need to ask for additional information to determine FFCRA eligibility
Prior to your return:
- Notify Human Resources prior to your return to work.
- Provide documentation that you are medically cleared to return, and stating any limitations or restrictions, if applicable.