Leaves
TO SUBMIT YOUR LARS ELECTRONICALLY, SCAN ALL OF THE LARS AND EMAIL TO:
Harizon Odembo: hodembo@peralta.edu
Alejandra Rodriguez: alejandrarodriguez@peralta.edu
Anthony Matchette: amatchette@peralta.edu
*Please include all three in the email.
*Please DO NOT send the LARs in separate emails for each person.
Contact Alejandra Rodriguez at alejandrarodriguez@peralta.edu if you have any questions regarding leaves benefits.
FORM FOR REQUESTING MEDICAL LEAVE
Medical Leave Request Form – revised 2019
FMLA & CFRA INFORMATION
FMLA Information (Eligibility Criteria)
FMLA Form – Employee’s Serious Health Condition
FMLA Form – Family Member’s Serious Health Condition
LEAVE OF ABSENCE REPORTING FORMS
COVID-19 sick leave reporting new
Click here for instructions on how to complete the LAR form.
PDF files