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Get DC PFL-MMC 2020-2024

You have a serious health condition as defined by the DC Paid Family Leave law. You must complete section 1 of the form. Your doctor or licensed health care provider must complete section 2 of the form. You may complete the filing process for Medical Leave benefits only after this form is completed and signed by your doctor. Please ensure that your health care provider completes all sections of the form or your claim may be denied. Using the online Paid Family Leave benefits portal availa.

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