NOTE: Please use the following site to lookup the employee number; this number may be used in place of the social security number when completing forms found on this site. http://eelookup.admsrv.ohio.edu/eelookup/

Forms on this site are available in one of the following formats: Microsoft Word, Microsoft Excel and Adobe Acrobat.

You can receive a FREE version of Adobe Acrobat by visiting http://www.adobe.com/.

• Forms HELP!

A- Forms
Anthem Medical Claim
Addendum to Administrative/Faculty Appointment for Unpaid Leaves
Administrators, Performance Development Assessment
AFSCME Performance Evaluation
Annual Certification of Emergency Services Status
Anthem, Dental Claim
Anthem Student Certification
Application for Family or Medical Leave  (OU FMLA #.01) 
ARP Vendor Change
Award Request, Employee

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B- Forms
Bargaining Unit Performance Evaluation
Beneficiary, Life Insurance
Benefits Enrollment (Microsoft Word)
Benefits, Dental Claim (Anthem)
Benefits, Evidence of Insurability Form
Benefits, Flexible Spending Account Reimbursement FlexPro 
Benefits, Mail Order Prescription
Benefits, Medical Claim (Anthem)
Benefits, Medical Claim
Benefits, Prescription Reimbursement (Rx Options)
Benefits, Vision - (Faculty & Administrative Only)
Benefits, Waiver to Stop Automatic Rollover FlexPro
Benefits, Waiver of Group Health Insurance 

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E- Forms
Educational Benefit, Employee 2009 (Excel)
Educational Benefit, Employee 2009 (pdf)
Educational Benefit, Employee 2008 (Excel)
Educational Benefit, Employee 2008 (pdf)
Educational Benefit, Qualified Dependents 2009 i.e. Spouse, Child, Domestic Partner (Excel)
Educational Benefit, Qualified Dependents 2009 i.e. Spouse, Child, Domestic Partner (pdf)
Educational Benefit, Qualified Dependents 2008 i.e. Spouse, Child, Domestic Partner (Excel)
Educational Benefits Qualified Dependents 2008 i.e. Spouse, Child, Domestic Partner (pdf)
EEO/AA Appraisal (Institutional Equity)
Employee Award Request
Employee Personal Data Change Notice
Employee Recognition, (Appendix A)
Employment Interviewer Evaluation
Employment Separation Checklist
Employment Verification, I-9
Enrollment, Benefits (Microsoft Word)
EnvisionRx, Mail Order Prescription
ERIP Statement of Intent

Evidence of Insurability

RETURN TO: Fort Dearborn Life Insurance Company, Attn: Medical Underwriting Dept. P.O. Box 655403, Dallas, TX 75265-5403, Fax: 1-972-996-9371

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H-I- Forms
Homeland Security, DMA

I-9 Employment Verification

Interim Base Wage Adjustment (Classified)
Interview, Employment Evaluation
Interviewer Evaluation
IPS, Mail Order Prescription

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M- Forms
Mail Order Prescription
Medical Certification Statement (Family Member) (OU FMLA #.05)
Medical Claim, Anthem
Mid-Year Base Wage Adjustment (Classified)

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O, P- Forms
Organ Donation Leave, Request for
Paid Time Off: Faculty and Staff (Excel)
Paid Time Off: Faculty and Staff (pdf)
Performance Development Assessment, Administrators
Performance Evaluation, AFSCME
Performance Management, Employee Activity Journal PM4
Performance Management, Employee Activity Journal PM4 (pdf)
Performance Management, Employee Self Evaluation PM5
Performance Management, Employee Self Evaluation PM5 (pdf)
Performance Management Review, Classified PM1*
Performance Management Review, Classified PM1 (pdf)*
Performance Appraisal for Classified Staff*
Performance Management, Supervisor Feedback PM3
Performance Management, Supervisor Feedback PM3 (pdf)
Performance Planning PM2
Performance Planning PM2 (pdf)
Personal Data Change Notice
Personal Time: Administrators (Excel)
Personal Time: Administrators (pdf)
Personnel Data Profile
Position Description Questionnaire (PDQ)
Position Modification Form (to be used when modifying title and/or content of position)
Position Search Committee Reference Check
Prescription, Mail Order
Prescription Reimbursement (Rx Options)
Prior State Service Request for Transfer
Probationary Evaluation, Classified Non Bargaining

*May use either Performance Appraisal or PM1 form.

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R- Forms
Recognition, Employee (Appendix A)
Reliance Disability (Return to Human Resources)
Request for Emergency Service Leave
Request for Organ Donation Leave
Request for Paid Time Off, Administrative
Resignation Form
Response to Employee Request for FMLA (OU FMLA #.03)

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S- Forms
Sample Offer Letter Administrator
Search Firm Recruitment Report- Part A
Search Firm Recruitment Report- Part B
Separation Checklist, Employment
Sick Leave: AFSCME Bargaining Unit Employees (Excel)
Sick Leave: AFSCME Bargaining Unit Employees (pdf)
Sick Leave: Classified Employees (Excel)
Sick Leave: Classified Employees (pdf)
Sick Leave, Conversion
Sick Leave: Faculty and Staff (Excel)
Sick Leave: Faculty and Staff (pdf)
Spouse, Educational Benefit
State Service, Prior (Request for Transfer)
Student Certification, Anthem
Supervisor Feedback PM3
Supervisor FeedbackPM3 (pdf)   

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