Forms

FMLA Packet	Metlife Medical Authorization
Metlife Attending Physcians Statement	Metlife Behavioral Health Assessment
Blue Cross Blue Shield Form	Metlife Dental Form
Davis Vision (Out of Network) Form

Records Review Request	Grievance Information Request
Lost Time	Expenses
Cope Payroll Deduction Card
DCRF Enrollment Forms	DCRF Monthly Reimbursement Mail To:  VERIZON NY/NE Regional Work and Family Committee Sajdah Muhammad 240 East 38th Street, Room 1567  New York, NY 10016

Verizon TAP	Scholarships
(Vz Tap Policies)	Enhanced Education Leave

Family Care Leave	Care for Newborn Children Leave
Gradual Return to Work	Education, Military, Civic, and Personal Leave