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This form is used by administrative and faculty employees that are benefits eligible to request donated time from the paid leave pool.
Employees complete this form to provide personal information, educational history, and license/certification information.
This form is completed by employees to submit a medical claim to Anthem.
Employees must complete this form each academic year when requesting educational benefits for a qualified dependent.
These forms are to be used by supervisors and managers in cases where there is reasonable suspicion that an employee is under the influence of drugs or alcohol.
This form is used by employees to request reimbursement for prescriptions paid out of pocket.
This form is completed by the department to request an incumbent review of an employee’s position.
Employees must complete this form each semester when requesting educational benefits.
This form is used to request an appeal to a position’s classification or mapping as a result of an incumbent review. This form is completed by an employee, their supervisor, and the Department Head.
Employees may elect to use accrued paid sick leave or to be placed on an unpaid medical leave of absence in the event of an occupational illness or injury.
This form is completed by employees at the time of retirement to elect a one-time conversion of unused accrued sick leave credit in accordance with section 124.39 of the Ohio Revised Code.
This form is used to submit institutional and professional claims for benefits for covered services received outside the United States, Puerto Rico, and the U.S. Virgin Islands.
This form gathers information from current student employees who are starting a new position.
This form is completed by the department to request changes to faculty and administrative appointments.
New and current employees should complete the appropriate tax forms to establish or update their withholding status.
Employees requesting supplemental life insurance above the guaranteed issue amount must complete the EOI submission.
This form is completed by employees and the professional provider to request leave for adoption or foster care.
This form is used to initiate direct deposit or update existing direct deposit account information.
This form allows an employee to establish a domestic partnership. The domestic partner can be a covered dependent for medical, educational, and sick leave benefits.
This form is completed by an employee and their supervisor in the event of a work-related injury, illness, or incident.
This form is used to request parental leave. Employees must provide the requested start and end dates for both the six weeks of unpaid leave and the six weeks of paid leave.
Completed by new employees to acknowledge that you will not contribute to Social Security.