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  • Medical Certification Form - City Of Riverside - Riversideca

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CITY OF RIVERSIDE FAMILY, MEDICAL, PREGNANCY DISABILITY AND/OR MILITARY CAREGIVER LEAVE MEDICAL CERTIFICATION Employee Information (To be completed by employee. Fill out all information that applies.).

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If possible, you must provide at least 30 days' advance notice for foreseeable events (such as the expected birth of a child or a planned medical treatment for yourself or of a family member). For events that are unforeseeable, we need you to notify us, at least verbally, as soon as you learn of the need for the leave.

Employees who need time off work to care for their own medical conditions or for a sick family member should request CFRA leave from their employers. Employee's may make this request verbally, but doing so in writing as soon as the need for leave is known is usually the best practice.

Online through Covered California, at or by calling 1-800-300-1506. Call DPSS at 1-877-410-8827.

FMLA is a federal program, while CFRA is state based in California. Simply being pregnant under FMLA qualifies, while CFRA only covers time off for pregnancy complications. It is more difficult to be covered as a domestic partner by FMLA than by CFRA.

Use this form to give employees notice of their rights under the California Family Rights Act (CFRA), and to designate leave as CFRA, to provide conditional approval of the request for CFRA leave if more information is necessary, or to deny the request.

California employees become eligible for CFRA leave if they have worked for the employer for at least 12 months and worked at least 1,250 hours within that time frame. The law covers part-time workers if they meet those two requirements.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232