Primary Caregiver Leave

EDSI provides 12 weeks paid leave at 100% of the employee’s regular pay rate (excluding overtime) following the birth or adoption of a child(ren). This leave must begin as of the date of birth or adoption and be used in one continuous block of time.

An employee will not accrue PTO during this leave of absence.

Employee's First Name

Last Name

Location/Program

Location/Program Address

Location/Program City State Zip

If your location is not listed above, please specify

Reason for leave

Please provide the due date or placement date

Please provide any other details you feel are important to share

If you are the child's primary caregiver, please complete the Primary Caregiver Paid Leave Certification form.

Click here to download the Primary Caregiver Paid Leave Certification form.

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Primary Caregiver Leave

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