Important:

Stay at home. Get COVID-19 Updates, Information, and Resources.

Request Family Medical Leave

Download
Family Medical Leave Request
Download
Family Medical Leave Time Reporting Form
Download
Family Medical Leave Medical Verification Form
Date Posted: September 9th, 2018 @ 1:02 PM
Last Updated: September 18th, 2018 @ 4:08 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