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Benefits

For a complete list of current Benefits forms, click here.

Child Development Center

• Waiting List Application Form

Compensation

• Compensation Request/Faculty Recruitment Form
• Action Verbs-Position Description Questionnaire
• Hospital Position Requisition Form
• Hospital Position Requisition Form Instructions
• Student Assistant Contracted Request and Approval Form

Technology & Data Services

• Second Access Proper Use Agreement (Confidentiality Agreement)

Employment

• Hire Letter Template for Temporary/Irregular Employees
• Employing Minors Request for Clearance Form and Instructions*
  
  * Clearance request and health enrollment form must be submitted to OH&S at least 2 weeks prior to hire date for timely processing.

On-The-Job Injury / Illness Program (OJI)

• OJI Instructions for Dept. Supervisors
• Initial Medical Evaluation Authorization
• Incident Report Form
  (Use only the Adobe Reader to complete this form or data loss may result.)
• How to Apply for OJI Benefits
• OJI Benefits Application
• Release of Information
• OJI Time Sheet

Performance Management

• Performance Evaluation Form (University)
• Performance Appraisal Form (Bi-Weekly)
• Performance Appraisal Form (Bi-Weekly) Instructions
• Performance Appraisal Form (Monthly)
• Performance Appraisal Form (Monthly) Instructions
• Performance Appraisal Form (Hospital)

Organizational Development

• Faculty & Staff Benevolent Fund
• Patent Agreement
• Employee Supervisor Checklist
• Individual Development Plan (Sample)
• Individual Development Plan (Blank)

Records Administration

• Application for Employment for 04 Irregular and 06 Student
• Employment Verification Form I-9
• Records Information Request Form
• EEO Self Identification Form
• UAB Statement of Understanding
  Regarding Additional Income for Returning Retiree
• Veterans and Individuals with Disability Self ID Form
  

FMLA Employee Illness

• Employee Request Form
• Employee Medical Certification Form
• Return to Work Request
• Authorization to Disclose Medical Information
• Intermittent Utilization Form (If Applicable)

FMLA Family Illness

• Employee Request Form
• Family Health Condition Certification Form (To be Completed by a Health Care Provider)
• Authorization to Disclose Medical Information
• Intermittent Utilization Form (If Applicable)

Military Qualfying Exgiency

• FMLA Military Request Form
• Certification of Qualifying Exigency for Military Family Leave

Military Serious Health Condition

• FMLA Military Request Form
  
• Certification for Serious Injury or Illness of a Covered Service Member

• Authorization to Disclose Medical Information
  
• Intermittent Utilization Form
  
• Request to Return Form
• Sick Time Donation Request Form
• Sick Time Donation Policy

Relations

• Separation Checklist for Supervisors
• Separation Checklist for Employees

Hospital HR

• Performance Management Process Form
• Hospital Professional Standards