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Pregnancy Disability Leave Compliance Checklist

Pregnant employees who are disabled by their pregnancy are eligible for as much as 17 weeks and three days of PDL. Use this form for each employee to keep track of the variety of documentation and tracking of other time off available to the employee during such a leave of absence. Consult with your practice policies or your employee manual to guide you with some of the questions.

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Updated on Tue, 09 Feb 2021 by Faizah