Disability and Family and Medical Leave (FMLA)

FMLAInstructions for Disability and FMLA

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave. At Delaware Valley OBGYN & Infertility Group, we understand your need to have FMLA or other disability forms completed.

To complete disability or FMLA forms for time off from work due to pregnancy or surgery, please make sure you fill out all of your paperwork in the sections marked ‘Employee’ and sign all employee signature areas before bringing the forms to the office. In addition to the forms provided by your employer, you will also need to print and complete our Disability Forms Request.

Please allow up to 7 to 10 business days for submissions to be completed.

Fee: (No Exceptions):

  • $10 Per Set of Forms If Picked Up in Person
  • $12 If Faxed

Forms can be Faxed to: (609) 896-3266

Emailed to: vchambers@LMA-LLC.com

Delivered to the office: during normal business hours.

If you have any questions, please call (609) 896-0777 ext. 232.

PLEASE NOTE – We cannot take responsibility for forms lost in the mail. It is your responsibility to provide the completed forms to your insurance company or employers. Please do not hand these forms to our physicians or nurses, as they see numerous patients a day and forms can be misplaced.

  • Link or Form Download
  • Link or Form Download
  • Link or Form Download
  • Link or Form Download

Our Locations

Lawrenceville Office

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2 Princess Rd Suite C, Lawrenceville, NJ 08648

East Windsor Office

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300B Princeton Hightstown Rd #202, East Windsor, NJ 08520

TELEHEALTH Now Available

Your safety during the Coronavirus crisis is our utmost concern.

In order to keep you and your loved ones safe, our OBGYN doctors, midwives and fertility specialist are now live offering TeleHealth virtual visits!

You can conference with us by video and discuss current problems or get advice about future treatment. Have any referral slips and insurance info handy and click the link below: