Families First Coronavirus Response Act Leave Form

The purpose of this Information Alert is to inform colleges and units regarding the Families First Coronavirus Response Act (FFCRA). The FFCRA leave form is now available online in PDF format on the UICHR website at: https://hr.uic.edu/covid-19-hr-guidance-to-managers-and-employees/ under “Additional Resources.”

The form consists of sections to be completed by both the employee and the college/unit HR representative. Please ensure employees are aware of the HR representative for their college/unit so requests for leave are submitted to the appropriate office.

For additional questions regarding leaves under the FFCRA, please send an email to the UIC HR Service Center Leaves listserv at uichrleaves@uillinois.edu. Leave inquiries for UI Hospital and Clinics employees should be sent directly to UI Hospital at uihloa@uic.edu.