Communications Workers of America Local 1102

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Forms

FMLA

Family Medical Leave Act (FMLA) Medical Certification Form

FMLA Revisions Q & A

MetLife

Attending Physician Statement

Authorization to Disclose Medical Information

Dental Expense Claim Form

Verizon Benefits

Dependent Care Reimbursement Forms

Anticipated Disability

Verizon Concesssion Telephone Service

Vision

Davis Vision Claim Form

** Remember to get a transaction confirmation if you fax your FMLA or Met Life paperwork in **



Contact Information
You can e-mail us at:
webmaster@cwa-1102.org

Telephone 718-420-1102 * FAX 718-447-4200 * Tape 718-482-3349

CWA LOCAL 1102 * 1110 South Ave  * Staten Island, NY 10314