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    Resource Library, Employment Practices, Laws and Regulations, California Family Rights Act (CFRA)

    Certification of Health Care Provider for Pregnancy Disability Leave, Transfer and/or Reasonable Accommodation

    December 18, 2020 7569
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    Form for use by employee requesting leave of absence from work under CFRA because of pregnancy, disability or reasonable accommodation.

    Download Certification of Health Care Provider Form (pdf)

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