Compliance Resources Pamphlets / Forms / Letters

RESOURCE LINKS
  • Department Of Workers' Compensation - DWC - California

  • Employer Resource & Assistance Network - EARN

  • Equal Employment Opportunity Commission - EEOC

  • Job Accommodation Network - Jan

  • Family Medical Leave Act

  • California Family Rights Act / Pregnancy Disability Leave / Family Medical Leave Act

  • American With Disabilities Act

  • Fair Employment Housing Act - Posters, Brochures and Fact-sheets

  • Fair Employment Housing Act

RESOURCE FORMS
California Family Rights Act

Description Published Link
English Brochure Dec 2017 DFEH-E03B-ENG
Spanish Brochure (Ley de Derechos de la Familia en California) Jun 2018 DFEH-E03B-SP
Certification Health Care Provider for Pregnancy Disability Leave, Transfer, and/or Reasonable Accommodation

Description Published Link
English Poster Jun 2017 DFEH-E10P-SP
Spanish Poster (Certificación Del Proveedor De Salud) Jun 2017 DFEH-E10P-ENG
CFRA Certification of Health Care Provider

Description Published Link
English CFRA Certification Dec 2017 DFEH-E11P-ENG
Spanish CFRA Certification Jun 2017 DFEH-CFRA-SP
Employment Discrimination Based on Disability

Description Published Link
English Brochure Dec 2017 DFEH-E01B-ENG
Spanish Brochure (Discriminación En El Empleo Basada En Discapacidad) Jun 2018 DFEH-E01B-SP
Family Care and Medical Leave (CFRA Leave) and Pregnancy Disability Leave

Description Published Link
Chinese Poster (家庭護理和醫療假(CFRA假)以及懷孕殘障假) May 2017 DFEH-100-21CH
English Poster May 2017 DFEH-100-21ENG
Korean Poster (가족부양 휴가 및 병가 (가주 가족 권리법 )와 출산 휴가) May 2017 DFEH-100-21K
Spanish Poster (Cuidado Familiar Y Ausencia Médica (Cfra) Y Ausencia De Incapacidad Por Embarazo) May 2017 DFEH-100-21SP
Tagalog Poster (Pagpapaalam Para Sa Pag-Aalaga Ng Pamilya At Mga Dahilang Medikal) May 2017 DFEH-100-21TG
Vietnamese Poster (Nghỉ Bệnh Và Nghỉ Để Chăm Sóc Gia Đình (Cfra Leave) Và Nghỉ Vì Suy Yếu Khi Mang Thai) May 2017 DFEH-100-21VT
Pregnancy Leave

Description Published Link
Chinese Brochure (怀孕休假) Jun 2018 DFEH-E02B-CH
English Brochure Dec 2017 DFEH-E02B-ENG
Korean Brochure (임신휴가) Jun 2018 DFEH-E02B-K
Spanish Brochure (Licencia Por Embarazo) Jun 2018 DFEH-E02B-SP
Tagalog Brochure (Pagbabakasyon Ng Buntis) Jun 2018 DFEH-E02B-TG
Vietnamese Brochure (Tạm Nghỉ Làm Vì Mang Thai) Jun 2018 DFEH-E02B-VT
Resources

Description Published Link
Employee's Request for Reasonable Accommodation Jun 2018 ERRA
Employer's Form for Reasonable Accommodation Jun 2018 EFFRA
Sexual Harassment: The Facts about Sexual Harassment

* Either the poster or the brochure can be distributed to employees to meet legal requirements

Description Published Link
Chinese Brochure (性骚扰) Jun 2018 DFEH-185-CH
English Brochure Dec 2017 DFEH-185-ENG
English Poster Dec 2017 DFEH-185P-ENG
Korean Brochure (성희롱) Jun 2018 DFEH-185-K
Spanish Brochure (Acosa Sexual: La Realidad Acerca del Acoso Sexual) Jun 2018 DFEH-185-SP
Spanish Poster (Acoso Sexual) Jun 2018 DFEH-185P-SP
Tagalog Brochure (Sekswal Na Panliligalig) Jun 2018 DFEH-185-TG
Vietnamese Brochure (Xách Nhiễu Tình Dục) Jun 2018 DFEH-185-VT
Transgender Rights in the Workplace

Description Published Link
Chinese Poster Jul 2018 DFEH-E04P-CH
English Poster Jul 2018 DFEH-E04P-ENG
Korean Poster Jul 2018 DFEH-E04P-K
Spanish Poster Jul 2018 DFEH-E04P-SP
Tagalog Poster Jul 2018 DFEH-E04P-TG
Vietnamese Poster Jul 2018 DFEH-E04P-VT
Workplace Discrimination and Harassment

Description Published Link
Chinese Poster (加利福尼亚州法律禁止工作场所歧视和骚扰) Jun 2018 DFEH-E07P-CH
English Poster Jun 2018 DFEH-E07P-ENG
Korean Poster (캘리포니아 법은 직장 내에서의 차별과 괴롭힘을 금지하고 있습니다) Jun 2018 DFEH-E07P-K
Spanish Poster (La ley Prohibe la Discriminacion y el Acoso en el Empleo) Jun 2018 DFEH-E07P-SP
Tagalog Poster (Batas Ng California Na Nagbabawal Sa Lugar Ng Trabaho Ng Diskriminasyon At Panliligalig) Jun 2018 DFEH-E07P-TG
Vietnamese Poster (Luật Ở California Cấm Kỳ Thị Và Sách Nhiễu Trong Sở Làm) Jun 2018 DFEH-E07P-VT
Workplace Harassment Guide

Description Published Link
Workplace Harassment Guide May 2017 DFEH-E08P-ENG
Workplace Rights for Members of the Military and Veterans

Description Published Link
English Poster Dec 2017 DFEH-E05P-ENG
Spanish Poster (Derechos Laborales De Miembros Del Ejercitoy Veteranos) Jun 2018 DFEH-E05P-SP

DISCLAIMER: The attached sample forms are outlined designed to provide accurate and authoritative information in a highly summarized manner in regard to the subject matter covered. They are provided with the understanding that Return to Work Partners is not engaged in rendering legal services. If legal assistance is required, the services of competent legal professionals should always be sought. These forms are samples and should be reviewed with competent legal counsel prior to use.

Reasonable Accommodation / Interactive Process
  • GENERIC EMPLOYER'S Request for Reasonable Accommodation Form
    Instructions: To be hand delivered or by mail to employee.

  • GENERIC EMPLOYEE'S Request for Reasonable Accommodation
    Instructions: To be completed by employee; delivered to Employer to initiation the Interactive Process

  • Additional forms are available up request by calling 877.984-7969 or by filling out the request form Employee's Request for Reasonable Accommodation ERRA.pdf

FMLA: Family Medical Leave
  • GENERIC Letter to Employee initiating the interactive dialogue / process post exhaustion of Family Medical Leave. Additional leave is a form of accommodation.

  • Additional forms are available up request by calling 877.984-7969 or by filling out the request form Employer's Form for Reasonable Accommodation EFFRA.pdf

Ergonomics Evaluations Forms & Resources
Ergonomic Equipment Catalogue

Description Published Link
Wrist Rests Jun 2018 Wrist_Rests.pdf
Telephone Headsets Jun 2018 Telephone_Headsets.pdf
Office Equipment Jun 2018 Office_Equipment.pdf
Monitor Arms - Mounts - Stands Jun 2018 Monitor_Arms_Mounts_Stands.pdf
Miscellaneous Jun 2018 Miscellaneous.pdf
Mice - Mouse Jun 2018 Mice_Mouse.pdf
Mice - Mouse Platforms Jun 2018 Mice_Mouse_Platforms.pdf
Keyboard Trays Jun 2018 Keyboard_Trays.pdf
Height Adjustable Desks Jun 2018 Height_Adjustable_Desks.pdf
Footrests Jun 2018 Footrest.pdf
Floor Mats Jun 2018 Floor_Mats.pdf
Ergonomic Office Chairs Jun 2018 Ergonomic_Office_Chairs.pdf
Ergonomic Lighting Jun 2018 Ergonomic_Lighting.pdf
Drafting Chairs Jun 2018 Drafting_Chairs.pdf
Document Holders Jun 2018 document_holders.pdf
CPU Holders Jun 2018 CPU_Holder.pdf
Chair Accessories Jun 2018 Chair_Accessories.pdf
Anti Glare & Privacy Screens Jun 2018 Anti_Glare_Privacy_Screens.pdf
Ergonomics

Description Published Link
Remote Chair Fitting Form Jun 2018 ERGO_REMOTE_CHAIR_FITTING_FORM.pdf
How to Select an Ergonomic Chair Jun 2018 Selecting_an_ergo_chair.pdf
Ergonomic Guidelines / Tip Sheet Jun 2018 Bacis_Ergonomic_Guidelines.pdf
Employee Self-Assessment Form Jun 2018 Ergo-Self-Assessment-06-09-2018-ESA.pdf

Additional forms are available up request by calling 877.984-7969 or by filling out the request form found on our CONTACT PAGE. Reach out to us, we are here to HELP!

RESOURCE LINKS RESOURCE FORMS DISCLAIMER: The attached sample forms are outlined designed to provide accurate and authoritative information in a highly summariz

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