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Human Resources

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2016 Health Insurance Enrollment / Change Form (PDF)

2016 Health Insurance Premium Surcharge Help Sheet (PDF)

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Accommodation Request for Disability or Serious Medical Condition (PDF)

Appointment Letter (from academic appt to pro staff) (MS Word)

Appointment Letter (from contract classified to pro staff) (MS Word)

Appointment Letter (moving from CNU to pro staff) (MS Word)

Appointment Letter (new to UW pro staff) (MS Word)

Appointment Letter (pro staff promotion or lateral) (MS Word)

Attendance Incentive Request for Payment of Unused Sick Leave (Campus) (MS Word)

Attendance Incentive Request for Payment of Unused Sick Leave (UW Medicine) (MS Word)

B

Background Report Disclosure and Authorization (PDF)

Behavioral Interviewing – Clerical/Administrative Support (MS Word)

Behavioral Interviewing – Management (MS Word)

Behavioral Interviewing – Professional/Technical Non-Clinical (MS Word)

Behavioral Interviewing – Research (MS Word)

Behavioral Interviewing – Skilled Trades (MS Word)

Behavioral Interviewing – Support Service/Paraprofessional Clinical (MS Word)

Behavioral Interviewing – Support Service/Technical Non-Clinical (MS Word)

Behavorial Interviewing – Professional/Technical Clinical (MS Word)

C

COBRA Continuation of Coverage Election (PDF)

Candidate Skills Questionnaire (PDF)

Career Enhancement Growth Program (MS Word)

Career Planning Resource (PDF)

Certification of a Dependent with a Disability (PDF)

Checklist – Direct Hire Temporary Employee (MS Word)

Checklist – New Hire (MS Word)

Checklist – Separating Employee (MS Word)

Checklist – Separating Harborview Employee (MS Word)

Checklist – Separating UWMC Employee (MS Word)

Checklist – Supplement for Employees Station Outside Washington State (MS Word)

Checklist – Transferring Employee (MS Word)

Child Care Payroll Deduction (PDF)

Classified Position Review Questionnaire (MS Word)

Classified Staff Temporary Salary Increase – Approval Request (MS Word)

Classroom Logistics Survey (PDF)

Compensation Change Request (MS Word)

Conditional Offer Template (MS Word)

Corrective Action Plan Form Only (MS Word)

Corrective Action Plan Instructions and Form (MS Word)

Criminal Conviction & Civil Finding History Questionnaire (PDF)

D

DRS Beneficiary Designation (PDF)

DRS Enrollment (PDF)

Declaration of Tax Status (PDF) - If you are adding a qualified domestic partner to your benefits coverage, you will need to provide a Declaration of Tax Status.

Disability Accommodation Health Care Provider Statement (PDF)

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Employee Authorization for Payroll Deduction to HSA (PDF)

Employee Work Reference Inquiry Documentation (PDF)

Extended Dependent Certification (PDF)

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FMLA (campus) Family Member’s Serious Health Condition (MS Word)

FMLA (campus) Military Family Qualifying Exigency (MS Word)

FMLA (campus) Notice (MS Word)

FMLA (campus) Notice Cover Letter (MS Word)

FMLA (campus) Personal Serious Health Condition (MS Word)

FMLA (campus) Serious Injury or Illness of Military Family Member (MS Word)

FMLA (med centers) Family Member’s Serious Health Condition (PDF)

FMLA (med centers) Family Member’s Serious Health Condition – Parental Leave (not birth mother) (PDF)

FMLA (med centers) Military Family Qualifying Exigency (PDF)

FMLA (med centers) Personal Serious Health Condition (PDF)

FMLA (med centers) Personal Serious Health Condition – Maternity / Pregnancy (PDF)

FMLA (med centers) Serious Injury or Illness of Military Family Member (PDF)

FMLA Information Summary (PDF)

Faculty/Staff Tuition Exemption Request (PDF)

Family Care Leave – Certification of Health Care Provider (MS Word)

Final Counseling Follow-Up Memo (MS Word)

Final Counseling Memo Scheduling Notice (MS Word)

Formal Counseling Memo Scheduling Notice (MS Word)

Formal Counseling Session Follow-Up Memo (MS Word)

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GAIP Mail Order Patient Registration (PDF)

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Harborview Children’s Center Waitlist Application (PDF)

Health Care Provider Certification Form – Cognitive (PDF)

Health Care Provider Certification Form – Cognitive & Parking (PDF)

Health Care Provider Certification Form – Parking (PDF)

Health Care Provider Certification Form – Physical (PDF)

Health Care Provider Certification Form – Physical & Parking (PDF)

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I-9 (PDF)

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LTD Enrollment / Change (PDF)

LTD Evidence of Insurability (PDF)

Leave Without Pay Election (PDF)

Leave of Absence Request – Basic (MS Word)

Leave of Absence or Modified Work Schedule Request (MS Word)

Life Insurance EOI (PDF)

Life and AD&D Insurance Enrollment and Change Form (PDF)

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Medical Student LTD Application (PDF)

Military Activation and Return-to-Duty Checklist (MS Word)

Military Duty Leave of Absence Request (MS Word)

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Official Personnel File Access Request (MS Word)

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PEBB Life Insurance Beneficiary Designation Request (PDF)

POD Course Registration (PDF)

PSTA Request for Extension/Pay Change (MS Word)

Parent/School Authorization (PDF)

Parental Leave for Parent other than Birth Mother – FMLA (campus) (MS Word)

Parental/Maternity Leave for Birth Mother – FMLA (campus) (MS Word)

Performance Evaluation – Classified Staff (MS Word)

Performance Evaluation – Structured Approach – Professional Staff (MS Word)

Performance Review – Conversation Approach – Professional Staff (MS Word)

Performance Review – Professional Staff Feedback (MS Word)

Performance and Development Plan Evaluation – Classified Non-Union (PDF)

Performance and Development Plan Expectations – Classified Non-Union (PDF)

Performance and Development Plan Instructions – Classified Non-Union (PDF)

Petition for Self-Pay Graduate Appointee Insurance While on Academic Leave (PDF)

Physician Assistants Student LTD Application (PDF)

Pre-Tax Transportation Plan Waiver (MS Word)

Premium Payment Change Form (PDF)

Prior Service Credit for Previous Washington State Employment (MS Word)

Privacy, Confidentiality, and Information Security Agreement (PDF) - For Medical Center Employees Only

Professional References (PDF)

Professional Staff Leave with Pay Application (MS Word)

Professional Staff Position Description (MS Word)

Professional Staff Position Review Employee Signature (MS Word)

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Recommendation for Dismissal (MS Word)

Reference Check Consent Form (PDF)

Reference Checking Consent and Authorization (PDF)

Registration Form for UW Employees Separated Through Layoff (PDF)

Relocation Incentive Payment Authorization (MS Word)

Relocation Payment Approval Request (MS Word)

Request for Approval of Outside Professional Work for Compensation – Faculty, Librarians, and Academic Personnel (PDF)

Request for Approval of Outside Work – Professional and Classified Staff (MS Word)

Request to Initiate Layoff (MS Word)

Research Activities (MS Word)

Research Scientist / Engineer Questionnaire (MS Word)

Retirement Checklist (PDF)

Retirement Status (PDF)

Roosevelt Commons Room Reservation Request (PDF)

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Salary Adjustment – Recruitment / Retention Form (MS Word)

Service Award Certificate Template (PDF)

Shared Leave – Donation (MS Word)

Shared Leave – Health-Care Provider Certification (MS Word)

Shared Leave – Organ Donor – Giving (MS Word)

Shared Leave – Organ Donor – Request to Receive (MS Word)

Shared Leave – Request to Receive – Domestic Violence, Sexual Assault, Stalking (MS Word)

Shared Leave – Request to Receive – Health Condition (MS Word)

Shared Leave – Request to Receive – Uniformed Services or Emergency Worker (MS Word)

Shared Leave – Uniformed Services – Donation (MS Word)

Shared Leave – Uniformed Services – Request to Receive (MS Word)

Student Employee Exception to Pay and Classification Schedule Form (MS Word)

Supplemental PSTA Questionnaire (MS Word)

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Telephone Reference Check (PDF)

Telework Plan and Agreement (MS Word)

Temporary Assignment (MS Word) - (hourly/monthly - new appointment)

Temporary Assignment Request for Extension/Pay Change (MS Word)

Temporary Pay Increase or Administrative Supplement Request (MS Word)

Training Action Plan (PDF)

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UTemp Personal Data (PDF)

UW Children’s Centers Waitlist Application (PDF)

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W-4 (PDF)

WSDCP Beneficiary Designation (PDF)

Washington State Employee Tuition Exemption Request (PDF)