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California Family Rights Act (CFRA)

California employers are required to comply with state-specific leave laws governing requests for leaves of absence, including the California Family Rights Act (CFRA). The CFRA provides eligible employees of employers with five or more employees, with 12 workweeks of protected leave under qualifying events for full-time employees, and a proportional number of workweeks for employees who work less than full-time. Employers are prohibited from interfering with the exercise of CFRA rights and from retaliating against an employee who takes CFRA leave.

Certification of Health Care Provider - Employees or Family Members Serious Health Condition

Use this DFEH form to request certification from a health care provider for CFRA leaves due to the employee’s own serious health condition or that of a family member.

This for may be used for CFRA and non-CFRA medical leaves of absence or other requested accommodations due to a qualifying disability or serious heath condition.