Disability Forms

ATTENTION PATIENTS:
Due to the high number of patient disability forms request  from  state disability and private disability insurance’s First Surgical Consultants has established a form fee for all additional, spouse,  partner, or caretaker (son, daughter, sister, brother , etc) leave forms, and all private disability insurance forms.

All California state disability insurance forms and extension forms: No Charge (this does not include California state paid leave for spouse or caretaker)
All Additional forms  that are subject to form fees are: private disability insurance, private life insurance forms, employer FMLA forms, employer spouse, partner, or caretaker family leave forms, union forms, all additional employer leave forms, and custom letters written by physician for time off request depending on the extent of the letter.

Please note: if you don’t qualify for California State disability insurance, because of your employment or plan on not applying for California state disability we will complete your employer disability forms at no charge, but any additional form will be subject to a fee.
For your convenience we have listed a link for California State Disability insurance application and California paid leave forms. 

DE-2501 - Claim for Disability Insurance Benefits

DE-2511 - Paid family leave.

First Surgical Office Locations

Oakland Office
365 Hawthorne Ave, #101
Oakland, Ca 94609
Ph# 510-465-5523
Fax# 510-832-6061

Berkeley Office
2999 Regent St #700
Berkeley, Ca 94705
Ph# 510-486-0818
Fax# 510-486-0819

Hayward Office
27001 Calaroga Ave, #4
Hayward, Ca 94544
Ph# 510-732-5731
Fax# 510-732-5739

Chinatown Office
388 9th St #218B
Oakland, Ca 94607
Ph# 510-839-0298 
Fax# 510-839-4389

Bariatrics Office (Summit South)
3100 Summit St, #2600
Oakland, Ca 94609
Ph# 510-869-8972
Fax# 510-869-6989


Comprehensive Cancer Center
2001 Dwight Way
Berkeley, CA 94704
Ph# 510-204-1634
Fax# 510-204-5749