The New York Workers’ Compensation Board has issued these official New York Paid Family Leave Program forms:
- Employee Paid Family Leave Opt-Out and Waiver of Benefits (Form PFL-Waiver)
- Request for Paid Family Leave (PFL-1) + Bonding Certification (PFL-2)
- Request for Paid Family Leave (Form PFL-1) + Release of Personal Health Information (Form PFL-3) + Health Care Provider Certification for Care of Family Member with Serious Health Condition (Form PFL-4)
- Request for Paid Family Leave (Form PFL-1) + Military Qualifying Event (Form PFL-5)
- Employer’s Application for Voluntary Coverage (No Employee Contribution) (Form PFL-135)
- Employer’s Application for Voluntary Coverage (Employee Contribution Required) (Form PFL-136)
- Statement of Rights for Paid Family Leave (PFL-271S)
The forms are also available directly from the State here, but I had trouble opening some of the files, so I wanted to make sure they are easily accessible for you!
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