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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/.

A- Forms


Addendum to Administrative/Faculty Appointment for Unpaid Leaves

Address Change (Personal Data Change Notice)

Administrators, Performance Development Assessment

Adoption Benefit Financial Reimbursement Form

AFSCME Performance Evaluation

Anthem, Dental Claim

Anthem International Claim, BlueCard Worldwide®

Anthem Medical Claim

Anthem Student Certification

ARP Vendor Change

Award Request, Employee

UP

B- Forms
Bargaining Unit Performance Evaluation

Beneficiary, Life Insurance

Benefits Enrollment (Microsoft Word)

Benefits Enrollment (pdf)

Benefits, Dental Claim (Anthem)

Benefits, Evidence of Insurability Form

Benefits, Flexible Spending Account Reimbursement FlexPro

Benefits, Medical Claim (Anthem)

Benefits, Medical Claim

Benefits, Vision - (Faculty & Administrative Only)

Benefits, Waiver to Stop Automatic Rollover FlexPro

Benefits, Waiver of Group Health Insurance

BlueCard Worldwide®, Anthem International Claim

UP

C- Forms
Campus Directory, Update

Certification, Student

Change, Employee Personal Data

Classification Review

Classified Development Program (CDP) Application

Classified, Interim Base Wage Adjustment

Classified Non Bargaining, Probationary Evaluation

Comp Time

UP

D- Forms
Data Profile, Personnel

Dental Claim
(Anthem)

Disability, OPERS
(Print DR1 & DR3)

Disability, Reliance (Return to Human Resources)

DMA, Homeland Security

Domestic Partner, Affidavit

Domestic Partner, Enrollment

Domestic Partner, Statement of Termination

Domestic Partner, Tax Information

UP

E- Forms

Educational Benefit, Employee 2010 (Word)

Educational Benefit, Employee 2010 (pdf)

Educational Benefit, Qualified Dependents 2010 i.e. Spouse, Child, Domestic Partner (Word)

Educational Benefit, Qualified Dependents 2010 i.e. Spouse, Child, Domestic Partner (pdf)

Educational Benefit, Employee 2009(Excel)

Educational Benefit, Employee 2009(pdf)

Educational Benefit, Qualified Dependents 2009 i.e. Spouse, Child, Domestic Partner (Excel)

Educational Benefit, Qualified Dependents 2009i.e. Spouse, Child, Domestic Partner (pdf)

EEO/AA Appraisal (Institutional Equity)

Emergency Service Leave Request

Employee Award Request

Employee Personal Data Change Notice

Employee Recognition, (Appendix A)

Employment Interviewer Evaluation

Employment Separation Checklist

Employment Verification, I-9

Essential Position Request Form (Hiring Freeze)

Evidence of Insurability
RETURN TO:
Fort Dearborn Life Insurance Company, Attn: Membership
1020 31st Street
Downers Grove, IL 60515


Exit Interview Questionnaire

Express Scripts Mail Order (Must register to complete form)

Express Scripts Reimbursement

UP 

F- Forms
Family Medical Leave Act (FMLA) Forms Overview

Family Medical Leave Act (
FMLA): Application for Family or Medical Leave
 (OU FMLA #.01)

Family Medical Leave Act(FMLA): Notice to Employees (OU FMLA #.02)

Family Medical Leave Act (FMLA): Eligibility Notice to Employer Under FMLA (OU FMLA #.03A)

Family Medical Leave Act (FMLA): Designation Notice Under FMLA(OU FMLA #.03B)

Family Medical Leave Act(FMLA): Certification of Physician/ Health Care Provider Employee) (OU FMLA #.04)

Family Medical Leave Act (FMLA): Medical Certification Statement
(Family Member or Caregiver Leave for Injured or Ill Service Member) (OU FMLA #.05)

Family Medical Leave Act (FMLA): Certification of Bonding Leave Due to Adoption or Foster Care(OU FMLA #.06)

Flexible Spending Account, Dependent Care, WageWorks

Flexible Spending Account, Healthcare, WageWorks

Fort Dearborn Life, Evidence of Insurability

FTE Reduction, Voluntary

UP

H-I- Forms

Homeland Security, DMA

I-9 Employment Verification

Incident Report (Workers Compensation)

Interim Base Wage Adjustment (Classified)

International Claim, Anthem BlueCard Worldwide®

Interview, Employment Evaluation 

Interviewer Evaluation

UP

J- Forms

Job Information Questionnaire (JIQ) - Classified

Job Information Questionnaire (JIQ)- IT

UP

L- Forms

Leave of Absence (Classified employees)

Leave of Absence/Work Related Injury

Leave,Organ Donation

Leaves, Unpaid- Addendum for Administrative/Faculty Appointments

Life Insurance
Beneficiary

UP

M- Forms

 

Mail Order, Express Scripts (Must register to complete form) 

Medical Claim, Anthem

Mid-Year Base Wage Adjustment (Classified)


UP

N- Forms


UP

O, P- Forms

Organ Donation Leave, Request for

Paid Time Off: Faculty and Staff (Excel)
NEW!

Paid Time Off: Faculty and Staff (pdf)  NEW!

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 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)NEW!

Personal Time: Administrators (pdf)NEW!

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 (Must register with Express Scripts to complete form) 

Prescription Reimbursement, Express Scripts

Prior State Service Request for Transfer

Probationary Evaluation, Classified Non Bargaining

*May use either Performance Appraisal or PM1 form.

UP

R- Forms

Recognition, Employee (Appendix A)

Reliance Disability (Return to Human Resources)

Relocation Expense Repayment Agreement  NEW!

Request for Organ Donation Leave

Resignation Form

Retirement Separation

UP

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)(NOT Required if using WorkForce system)

Sick Leave: Classified Employees (pdf)  (NOT Required if using WorkForce system)

Sick Leave, Conversion

Sick Leave: Faculty and Staff (Excel) NEW!

Sick Leave: Faculty and Staff (pdf) NEW!

State Service, Prior (Request for Transfer)

Student Certification, Anthem

Supervisor Feedback
PM3

Supervisor FeedbackPM3 (pdf)  

UP

U- Forms

Unacceptable Behavior Incident Report
Unpaid Leaves- Addendum for Administrative/Faculty Appointment

UP

V- Forms
Vacation: Faculty and Staff (Paid Time Off) ExcelNEW!

Vacation: Faculty and Staff (Paid Time Off) pdfNEW!

Vision Claim (Anthem)
(Faculty & Administrators)

Voluntary
FTE Reduction

UP

W- Forms

WageWorks, Flexible Spending Account- Dependent Care

WageWorks, Flexible Spending Account- Healthcare

Waiver of Group Health Insurance, Benefit

Workers Compensation, Incident Report

UP


Ohio University Human Resources
169 West Union Street
Human Resources and Training Center
Athens, OH 45701
Phone: (740) 593-1636 | Fax: (740) 593-0386
 
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