Employee Relations Forms

Grievance Form

• Application for Discretionary Review Form
• Formal Grievance Form
• Formal Grievance Form FAQ

ADA Accomodation

• ADA Accommodations Request Form
• ADA Medical Release Form

Harassment Form

• Harassment Incident Report Form

Notice of Separation

• Notice of Separation Form

Statement of Corrective Action

• Statement of Corrective Action Form
• Statement of Corrective Action Form – Juvenile

Performance Review Forms

• Supervisory Appraisal Form
• Non-Supervisor Appraisal Form

Record of Counseling

• Record of Counseling Form

Family and Medical Leave (FMLA) and Other Leave Forms:

Request for FMLA Leave Form

FMLA Designation Form

Notice of Eligibility and Rights

Certification of Qualifying Exigency

Certification of Health Care Provider – Family Member

Certification of Health Care Provider – Employee

Certification of Military Service Member

Certification of Veteran for Military Caregiver Leave

Leave of Absence Form

Primary Caregiver-Medical Certification Form

For FMLA/LOA questions please contact CareWorks Absence Management at 1-888-436-9530 or visit https://timeoff.careworksabsence.com

If you have policy related questions, please contact your H.R. Representative.

Catastrophic Vacation and Sick Leave Forms:

Catastrophic Leave Policy

Donation Form

Request Form

Medical Certification Form

Work Schedule Forms (Chapter 82-32):

Flexible Work Hours Request Form

Telecommuting Request Form

Telecommuting Request Form (Short-term)

Employment Forms (Chapter 86)

Background Investigation Authorization Form

Emergency Contact Form

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