Disability Office Services

The Disability Office is the centralized location for the processing of FMLA and commercial disability paperwork for patients and families.  

  • Family Medical Leave Forms
  • Short and Long Term Commercial Disability Insurance Forms
  • Cancer Policy Forms
  • Travel Cancellation Insurance Forms
  • School Loan Deferment Forms
  • Credit Card Protection Insurance Forms

For additional information about your rights regarding FMLA or disability, please visit the U.S. Department of Labor website.

Social Security Disability Applications are not processed in this office. Please contact your social worker via the Social Work Office at (813)745-8407 to assist you or apply directly online here.

Completed forms are available for viewing on the Moffitt Patient Portal. All forms are completed at no charge.

How to Get Started

  1. Obtain forms from employer/ insurance provider. The Disability Office is not able to provide blank forms.
  1. If applying for FMLA: Complete an FMLA worksheet with key information about your request.
  1. If applying for Disability/Cancer Policy/Travel Insurance: Complete a Release of Information (ROI) authorizing our Disability Office to disclose your medical information to your Disability provider.
  1. Submit all forms by fax to (813) 745-2002 or via email to disabilityoffice@moffitt.org or hand deliver to the Disability Office at Moffitt Magnolia Campus, first floor, MCC 1117.
  1. Upon completion, forms will be available for viewing on the Patient Portal.

Contact or Visit

Disability Office, Moffitt Magnolia Campus
First floor, Room MCC-1117
Email: disabilityoffice@moffitt.org
Phone: (813) 745-2356
Fax: (813) 745-2002