Employee Relations Forms

Records Building - 500 Elm Street, Suite 4100, Dallas, TX 75202
Phone: (214) 653-7638 • Fax: (214) 653-7608

Employee Relations Forms

To open and print a copy, click on the form name.

Grievance Forms:

• Application for Discretionary Review Form
• Formal Grievance Form
• Formal Grievance Form – Juvenile Department Only
• Formal Grievance Form FAQ
• Formal Grievance Form – Sheriff Employees Only

ADA Accommodation Forms:

• ADA Accommodations Request Form
• ADA Medical Release Form

For ADA Accommodation 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 HR Representative.

Complaint Report:

• Complaint Report Form

Notice of Separation Form:

• Notice of Separation Form

Statement of Corrective Action Forms:

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

Performance Review Forms:

• Supervisory Appraisal Form
• Non-Supervisor Appraisal Form

Record of Counseling Form:

• Record of Counseling Form

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

Please note, as of November 11, 2019 our FMLA leave provider was re-branded from York to Sedgwick. Click here for more information.

• COVID-19 Emergency Paid Sick Leave
• 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 Sedgwick at 1-888-436-9530 or visit https://timeoff.yorkrisk.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

Employment Forms (Chapter 86):

• Background Investigation Authorization Form
• Emergency Contact Form
• Click Here to View Hiring Policy