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New York City Health + Hospitals (NYC Health + Hospitals) – HRSS Leaves Administration fax number

(646) 694-6590

HRSS Leaves Administration (Leaves of Absence)

Used for: Submitting leaves of absence paperwork (LOA) and handling related FMLA/Paid Family Leave processes; intake and status communications with HRSS Leaves Administration.

Fax destination details

Department
HRSS Leaves Administration (Leaves of Absence)
Purpose
Submitting leaves of absence paperwork (LOA) and handling related FMLA/Paid Family Leave processes; intake and status communications with HRSS Leaves Administration.
Form
FMLA Form 2678 — Certification of Health Care Provider for Family Member's Serious Health Condition – Family and Medical Leave Act (FMLA) Form 2678
Address
55 Water Street, 26th Floor, New York, NY 10041
Voice phone
646-694-6590

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  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
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Submit forms to HRSS Leaves Administration; refer to the agency's FMLA/LOA guidelines for eligibility and submission requirements.

Review official form instructions

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