FMLA CFRA Designation Notice - Spanish

Approval/Conditional Approval/Denial

Use this form to designate leave as FMLA/CFRA, to provide conditional approval of the request for leave if more information is necessary, or to deny the request.

 
Preview
To see premium content, sign in below or get HRCalifornia.
​​
As of August 18, 2014, a recent site upgrade requires you
to reset your password now if you haven’t done so already.
Email
Password
Remember Email
Not a Member? Try HRCalifornia free for 15 days.​

You need Adobe Acrobat Reader 8.1 or later to view PDF forms.