Pediatrics Staff and Faculty Disability Leave Request Form

Faculty and Staff should complete the following form to notify the necessary people in Pediatrics of anticipated upcoming disability leaves.

 

Disability Leave: Disability is a type of leave for your own, non-work related illness or injury.

Family Care & Parental Bonding Leave: Care for an immediate family member suffering from a serious health condition or bond with your newborn, foster child or adopted child.

Maternity Leave: Pregnancy-related leave includes pre-partum and post-partum disability leave, as well as bonding time.

Other Types of Leave: Other types of leave include military, personal, and more.

 
 

The following questions will change depending on which option you choose.