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    Family and Medical Leave Act (FMLA)

    Forms and Resources

    If you have any FMLA related questions, please contact Joan Zaw and Debbie Poon.

    • CUNY FMLA Leave Policy
    • CUNY FMLA Request Form
    • CUNY Certification of Health Care Provider Form for Employees Serious Health Condition
    • CUNY Certification of Health Care Provider Form for Family Member’s Serious Health Condition
    • CUNY Certification of Family Relationship
    • CUNY Certification of Health Care Provider Form for Serious Injury or Illness of a Veteran – Military Caregiver Leave
    • CUNY Certification of Health Care Provider Form for Serious Injury of Illness of a Current Service member  – Military Family Leave
    • CUNY Certification of Qualifying Exigency for Military Family Leave
    • CUNY Notice of Eligibility and Rights and Responsibilities
    • CUNY Designation Notice
    • CUNY Fitness-For-Duty Certification

    Non-FMLA Forms and Resources

    An employee who may not be eligible for FMLA Leave may apply for Non-FMLA Medical leave.

    • CUNY Application for Non-FMLA Medical Leave
    • CUNY Non-FMLA Medical Leave Designation Form
    • CUNY Non-FMLA Fitness-For-Duty Certification

    FFCRA/COVID-19 New York Sick Leave

    The Families First Coronavirus Response Act (FFCRA) requires certain employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to COVID-19. Leave under the Families First Coronavirus Response Act has expired effective September 30, 2021.

    Employees who are subject to a mandatory or precautionary order of quarantine or isolation due to COVID 19 are provided with up to fourteen days (10 working days) of paid sick leave at their regular rate of pay with no charge to their accruals.  Employees who are able to work remotely are not eligible for this benefit.

    Use the link below for more information on New York State’s COVID Leave benefits and eligibility.

    COVID-19 New York Sick Leave Reference Guide

    Other Leave:

    • Bereavement Leave
    • Military Leave
    • Paid Family Leave
    • Parental Leave
    • Time and Leave Summaries by Job Title

    Office of Human Resources One Bernard Baruch Way, Box D-0202 (New York, NY 10010) 646-660-6590
    Human.Resources@baruch.cuny.edu
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    Baruch College | One Bernard Baruch Way
    55 Lexington Avenue (at 24th Street) | New York, NY 10010
    646-312-1000
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