Forms for FFCRA Employee Leave

The Families First Coronavirus Recovery Act requires certain employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to COVID-19. These provisions will apply from April 1, 2020, through December 31, 2020.

If you feel that you qualify under The Families First Coronavirus Recovery Act, you MUST FIRST complete the FFCRA Qualification Leave Form.  A link to the FFCRA Qualification Leave Form is available on the bottom of this page.

Any leave request must be sent to the District Office for review.  The Superintendent of Schools will make the final determination regarding qualifications.  Qualifying reasons are listed below.  Request forms should be emailed to Robin Hanson, Human Resources Coordinator: rhanson@proctor.k12.mn.us

QUALIFYING REASONS FOR LEAVE RELATED TO COVID-19
An employee is entitled to take leave related to COVID-19 if the employee is unable to work, including unable to telework, because the employee:

1.    is subject to a Federal, State, or local quarantine or isolation order related to COVID-19;

2.    has been advised by a health care provider to self-quarantine related to COVID-19;

3.    is experiencing COVID-19 symptoms and is seeking a medical diagnosis;

4.   is caring for an individual subject to an order described in (1) or self-quarantine as described in (2)

5.     is caring for his or her child whose school or place of care is closed (or child care provider is unavailable) due to COVID-19 related reasons; or

6.     is experiencing any other substantially-similar condition specified by the U.S. Department of Health and Human Services.

To Apply For Extended Leave Under the FFCRA,  Access And Complete The DocuSign Request Form For Extended Leave​​​​​​​

If you have any questions email Superintendent John Engelking:   jengelking@proctor.k12.mn.us

Or call Robin Hanson: 218-628-4934 ext 1014, Steve Anderson 218-628-4934 ext 1016, John Engelking 218-390-9860

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