HR Forms
Benefits
- Affidavit of a Qualifying Adult (PDF- must download to electronically sign)
- Anthem Major Medical Claim Form (PDF)
- Optum Reimbursement Instructions & Claims Form (PDF)
- Health Information Authorization (DOC)
- Voluntary Benefit Cancellation Form(PDF)
Leave Forms
Continuous or intermittent leave for self:
- Family & Medical Leave Request Guidance
- Employee Request for Family Medical Leave - Employee's Serious Health Condition
- Employee Request for Family Medical Leave - Birth, Adoption or Placement of a Child
- Employee Request for Temporary Medical Disability Leave (Used when FMLA is exhausted or unavailable)
- Administrator Request for Family Medical Leave (Administrators Only - Submit to Office of the President of Provost as appropriate)
Continuous or intermittent leave to care for someone else:
- Family & Medical Leave Request Guidance
- Employee Request for Family Medical Leave - Family Member's Serious Health Condition
- Employee Request for Family Medical Leave - Ill/Injured Servicemember
- Employee Request for Family Medical Leave - Ill/Injured Veteran
- Employee Request for Family Medical Leave - Qualifying Exigency For Military Family Leave
Other Leave
Compensation
Employee Relations
- Americans with Disabilities Act Accommodation (DOC)
- Discriminatory Conduct Complaint Form
- Performance Evaluation Form
- Performance Employee Self-Assessment Form
- Grievance Form (PDF)
- Exit Surveys