Front desk leave and pay checklist
A printable from Clinic guide to leave and pay. Fill it in by hand. Nothing you write is collected by this website.
Front desk leave and pay checklist
At check in, ask: "Do you need a note or form for work or for EDD?"
If the patient cannot work (own illness, injury or pregnancy)
- Tell them to file an SDI claim (online with SSN, or paper DE 2501 without one)
- Get their receipt number (R plus 15 digits) for online certification
- Provider certifies within 49 days of the start date
- Give an estimated return date, not "unknown"
If the patient is caring for a sick family member
- Family member's provider certifies DE 2501F Part D within 41 days
- Include time needed for care
If the employer wants a note for job protected leave
- Leave reason, start date, expected length
- No diagnosis unless the patient asks
If the patient needs changes at work
- Specific changes, how long, signed on letterhead
Before they leave
- Gave EDD numbers: DI 1-800-480-3287, PFL 1-877-238-4373 (press 3 for an interpreter)
- Reminded them: SDI and PFL pay but do not protect the job; ask the employer about leave too
- Gave paper forms if they have no SSN
From Clinic guide to leave and pay. Facts checked October 21, 2026. Free information, not legal or medical advice.