Request For Formal Leave Of Absence Form - California State University Fullerton (Page 14 of 18) in pdf

Request For Formal Leave Of Absence Form - California State University Fullerton Page 14

Clear

What's Next?

Now that you have read and completed the form(s), and made certain that all fields are accurate, the next step:

Print, sign, obtain all necessary approval signatures and forward completed forms along with supporting

documentation (Certification of Health Care Provider for all medical leaves) to Payroll, Benefits and

Retirement Services, CP-770.

Please note: The Certification of Health Care Provider form must be submitted for all Medical Leaves and

Extensions. A note from the attending physician will not be accepted in lieu of the Certification of Health Care

Provider form.

Payroll, Benefits and Retirement Services will provide a written notice to you and your department outlining the

details of the leave including anticipated return date

I have read the instructions above

Request For Formal Leave Of Absence Form - California State University Fullerton Page 14