Maternity Leave Form

Maternity Leave Form
Name*

First NameLast Name
Are you taking a medical leave before your maternity leave? If so, please provide Dr note to benefits@arcus.email and karen@arcus.email
Estimated Maternity Leave Start Date *

MonthDayYear
Date
Duration of Maternity Leave*

12 months18 months
Estimated Return To Work Date*

MonthDayYear
Date
Please contact Melanie Shanley at Melanie@arcus.email when the official Maternity Leave begins.
Please also Contact Melanie at Melanie@arcus.email 4 weeks prior to your return to work date to set up your schedule.
Should be Empty: