Leave Request/FMLA

• Employee should complete the Leave Form
• The physician/surgeon should complete the FMLA form.
• Once completed, please return these forms via email to hrdepartment@westfordk12.us or drop them off in a sealed envelope to the HR Office.

FMLA Request Form

Certificate of Health Care Provider - Employee Health

If you are a subscriber to our voluntary disability insurance, you can file a claim.

• When to File: Report your claim as soon as you know you will be absent for more than your 7 day waiting period (or up to 4 weeks in advance for planned leaves like surgery).
• Information You'll Need:
  • Employer Name: Westford Public Schools
  • Group Policy Number:  162241 School Division
  • Social Security Number
  • Physician contact info.
• Filing a Claim with The Standard:
  • Call: 800-368-1135 (Monday–Friday, 8:00 AM – 8:00 PM)
  • Online (Fastest): Visit www.standard.com and click "File a Claim."
  • Paper Form: Download The Standard Disability Claim Packet (PDF).