Division of Temporary Disability & Family Leave Insurance - Contact Us Form

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Use this email form to ask questions about our programs or about your current claim.

Fill out the form below as completely as possible. Enter details about your issue or inquiry so that we may respond more accurately. We will respond within 2 business days by email.

Remember, if you have a current claim, you can also obtain information from our website.

If you are a healthcare provider or employer, we cannot reveal specific information about a claim without the written consent of the claimant.

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(333)333-3333
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yourname@abc.com
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