Co-Employment, COVID-19, Employee Leave

Form: Request for Emergency Sick Leave

Employees requesting emergency sick leave under the Families First Coronavirus Response Act (FFCRA) must complete the proper form and provided the information and documentation requested therein. 

Click the button below to access, download and complete the Request for Emergency Sick Leave .pdf.

Download Request for Emergency Paid Sick Leave

Thanks for your feedback.

We're confident we can help. With our large group buying power we're able to help small and medium size businesses offer great benefit packages to their employees while keeping the costs reasonable.

Give us a call or email us for more info.

800.454.2446 |