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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

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Leaves of Absence Both FMLA and CFRA allow eligible employees to take leaves for serious health conditions. Childbirth or complications relating to childbirth or pregnancy would qualify under FMLA as a serious health condition.
Will I Be Paid During Leave? Employers are not required to provide paid pregnancy disability leave. However, an employee may use accrued paid leave during this time, such as vacation, sick leave, or paid time off (PTO).
Interaction Between PDL & Baby Bonding ? FMLA covers both pregnancy and Baby Bonding; therefore, FMLA runs concurrently with PDL while the employee is disabled by pregnancy. PDL and CFRA leave cannot run concurrently since CFRA leave does NOT cover pregnancy.
The FMLA also provides leave for pregnancy disability that may run concurrently with PDL if an employee is eligible for both.
Pregnancy Disability Leave (PDL) is a California state law that provides eligible employees with unpaid, job-protected leave in the event of a pregnancy, childbirth, loss of pregnancy, and/or pregnancy-related physical and mental conditions. Eligible employees may take up four months of leave per pregnancy.