Share Your Story: Dads Need Paid Leave!
Paid family and medical leave is critical to new parents and caregivers. Are you a dad or dad-to-be who supports #PaidLeave4CT? We want to hear from you! Complete the form below and share your reason for supporting paid family and medical leave for all Connecticut workers.

**NOTE: answers to question #3 "why is paid family and medical leave important to you personally?" will be posted on our website and social media pages using your first name, last initial and town of residence. If you'd like to participate in this survey but would like to do so anonymously, please check that box in question #9.

What type of leave have you ever needed to take?
Was the leave you took paid?
Why is paid family and medical leave important to you personally? Why is access to paid family and medical leave so important for fathers generally? *
Your answer
Do you know what leave is available for new fathers at your current job? Is this different than what's offered to new mothers? (note: answers to this question will not be posted publicly)
Your answer
Name (First and Last) *
Your answer
Email Address *
Your answer
Town and Zip Code *
Your answer
How would you like to share your story? *
Would you like to subscribe to receive occasional action alerts from the Campaign for Paid Family Leave? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service