Disability and FMLA Forms

The SOS Disability Department is here to support you.

The Disability Department can be reached:
SOS Disability Hotline Phone 315-418-4067 
SOS Disability Fax: 315-552-6047

Important Forms:
SOS HIPAA Release
Paid Family Leave Form

For Paid Family Medical Leave: Any forms needed to be completed to assist a family member for longer than 7 consecutive days, please discuss those details with the physician in advance.

All forms are completed in date order after three stipulations have been met:

      1. The provider’s medical portion has been completed
      2. Payment for completion has been received. 
      3.  A completed and signed HIPAA release with fax number to forward the forms to, has been provided.


A $15.00 processing fee is charged for each form and is expected prior to form completion.

The following forms are exempt from the $15.00 processing fee: Medicaid/Public Assistance/DSS and return to work forms.


Our Disability/Forms Department makes every effort to complete forms quickly, but it will generally take 10 business days (after all stipulations outlined above have been met), for the form(s) to be completed. While our turnaround time is often within the 10 business days, occasionally circumstances beyond our control arise resulting in delays which is unavoidable, and we apologize. We understand the importance of completing these forms as soon as possible and we will make every effort to do so.