NIH Leave Bank recipient application
- Fax Cover Sheet (NIH 2941)
- Application (NIH 2940)
- Authorization to Disclose Information (NIH 2923)
- Medical Documentation Request
- Recipient Application Checklist
- Policies and Procedures
- Leave Bank Membership Video
- Donate to the Leave Bank Video
- Informational Videos
- Comparing: Leave Bank and VLTP
- Leave Bank Recipient Success Stories
Please visit our Leave Bank homepage for more information.
For questions, email LeaveBank@od.nih.gov or call 301-443-8393.