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EMERGENCY PAID SICK LEAVE REQUEST
Employees requesting Emergency Paid Sick Leave (ESL) pursuant to the Families First Coronavirus Response Act (FF CRA)
must complete this form. You must provide as
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How to fill out emergency paid sick leave

How to fill out emergency paid sick leave
01
To fill out emergency paid sick leave, follow these steps:
02
Determine if you are eligible for emergency paid sick leave. This can depend on factors such as your employment status and company size.
03
Obtain the necessary documentation, such as a medical certification or government order, to support your need for emergency paid sick leave.
04
Inform your employer about your intention to take emergency paid sick leave. Provide them with the required information and documentation.
05
Fill out any relevant forms or paperwork provided by your employer for emergency paid sick leave.
06
Submit the filled-out forms and documentation to your employer according to their specified procedures.
07
Keep a copy of all the submitted forms and documentation for your records.
08
Follow any additional instructions or requirements provided by your employer for ongoing communication and updates during your absence.
09
Cooperate with your employer in providing any necessary updates or additional documentation as required.
10
Once you have recovered or no longer need emergency paid sick leave, inform your employer and provide any required documentation for closure of the leave period.
11
Maintain open communication with your employer to ensure a smooth transition back to work and any necessary follow-up actions.
Who needs emergency paid sick leave?
01
Emergency paid sick leave is needed by individuals who meet certain eligibility criteria and are facing situations that require them to take time off from work due to the following reasons:
02
- Being under a federal, state, or local quarantine or isolation order related to COVID-19.
03
- Advised by a healthcare provider to self-quarantine due to COVID-19 concerns.
04
- Experiencing COVID-19 symptoms and seeking a medical diagnosis.
05
- Caring for an individual subject to quarantine or isolation order or advised to self-quarantine.
06
- Caring for a child whose school or place of care is closed or unavailable due to COVID-19 precautions.
07
- Experiencing any other substantially similar condition as specified by the Secretary of Health and Human Services.
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What is emergency paid sick leave?
Emergency paid sick leave is a benefit that allows employees to take paid time off for specific reasons related to public health emergencies.
Who is required to file emergency paid sick leave?
Employers are required to provide emergency paid sick leave to eligible employees.
How to fill out emergency paid sick leave?
Employees can fill out emergency paid sick leave request forms provided by their employer.
What is the purpose of emergency paid sick leave?
The purpose of emergency paid sick leave is to ensure employees can take time off work without losing pay in specific situations.
What information must be reported on emergency paid sick leave?
Employees must report the date of leave, reason for leave, and any supporting documentation.
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