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Coronavirus Leave Request Form LORD Employees requesting 1) Family First Paid Coronavirus Leave, or 2) Emergency Family and Medical Leave (FMLA) can use this form to request leave in accordance with
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How to fill out family first coronavirus response

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How to fill out family first coronavirus response

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Step 1: Obtain the Family First Coronavirus Response Act (FFCRA) form from the official website or your employer.
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Step 2: Fill in your personal information such as name, address, contact details, and Social Security number.
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Step 3: Indicate the reason for your need for leave, whether it is due to your own COVID-19 diagnosis, caring for someone with COVID-19, or childcare responsibilities.
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Step 4: Provide the dates for which you are requesting leave and the duration of the leave needed.
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Step 5: Attach any supporting documents required, such as a doctor's note or a school closure notice, if applicable.
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Step 6: Sign and date the form, affirming the accuracy of the information provided.
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Step 7: Submit the completed form to your employer as instructed, whether it is through email, mail, or in person.
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Step 8: Follow up with your employer to ensure that your request has been received and processed.
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Step 9: Keep a copy of the filled-out form for your records.

Who needs family first coronavirus response?

01
Employees who are eligible for protections under the Family First Coronavirus Response Act (FFCRA) typically need to fill out the family first coronavirus response form.
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This includes individuals who work for private employers with fewer than 500 employees and certain public employees, who are entitled to paid sick leave or expanded family and medical leave for specific COVID-19 related reasons.
03
Additionally, employees who need to take time off work due to their own COVID-19 diagnosis, caring for someone with COVID-19, or childcare responsibilities may need to fill out this form to request leave.
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The Family First Coronavirus Response Act (FFCRA) is a mandatory federal law that provides paid sick leave and expanded family and medical leave for specified reasons related to COVID-19.
Employers with fewer than 500 employees are required to provide paid sick leave and expanded family and medical leave under the FFCRA.
Employers can provide the required paid leave to eligible employees, keep accurate records of the leave provided, and document the reasons for providing leave.
The purpose of the FFCRA is to help employees affected by COVID-19 by providing paid sick leave and expanded family and medical leave.
The leave must be reported by the employer, including the dates of leave and reasons for leave.
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