Forms

UConn Health building

Alien’s Change of Address Card (AR-11)

Alien Data Collection

Authorization and Release

Background Information Sheet

Candidate Selection

CO-931h

CO-999

Compensatory Time Authorization for UHP

Direct Deposit Authorization and Input

Dual Employment Request

Employment Eligibility Verification

Evaluation, Managerial/Confidential Employee Guidelines

Evaluation, Confidential Self

Evaluation, Confidential Supervisor

Evaluation, Confidential Goals

Evaluation, Managerial Goals

Evaluation, Managerial Self

Evaluation, Managerial Supervisor

FMLA-HR1 Employee Request

FMLA-DOL-WH384: Certification for Qualifying Exigency for Military Family Leave

FMLA-DOL-WH385: Certification for Serious Injury/Illness of Covered Service Member for Military Family Leave

International F-1 Checklist

International J-1 Checklist

Managerial/Confidential Merit Increase Recommendation

Medical Certificate, Caregiver

Medical Certificate, Employee

Name/Address Change

Payroll Check Pick-Up Authorization

Personnel Transaction Request (PTR) Form

Reclassification Request - All UConn Health Positions

Reclassification Request/Application for Examination - Classified

Reclassification Request, Duties Questionnaire - Classified

Reclassification Request, Position Information Questionnaire - Managerial & Confidential

Reclassification Request, Position Information Questionnaire - UHP

Request for Payment of 1199 Compensatory Time

Request for Payment of UHP Compensatory Time

Request for Establishment of ORG

Request to Hire

Separation of Employment Clearance

Temporary Service in Higher Classification, Classified

Temporary Service in Higher Classification, Unclassified/UHP

Tuition Reimbursement Application for Classified Employees

Tuition Reimbursement Application for Managerial/Confidential Employees

Tuition Reimbursement Application for UHP Members

Tuition Reimbursement Application for Conference Reimbursement, UHP Members

Tuition Waiver Reciprocal Tution Agreement Application

Tuition Waiver Request for Managerial and Confidential Employees

Tuition Waiver Request for UHP Employees

UHP Position Information Questionnaire

Unpaid Experience Request Form

Violent Incident Report

Voluntary Schedule Reduction Program (CT-HR-7c)

W-4 CT

W-4 Federal

Workers’ Compensation Concurrent Employment and Third Party Liability (DAS Form PER-WC 211)

Workers’ Compensation Filing Status and Exemption (WCC Form1A)

Workers’ Compensation Hearings Form 226

Workers’ Compensation Medical Appointments Form 226

Workers’ Compensation Use of Accrued Leave (Comptroller Form DAS-WC-715)

Workers’ Compensation Worker Status Report (DAS Form 208)

Workers' Compensation Claim Packet