Employee & Labor Relations Forms
Form
Use
Alcohol & Drug Reasonable Suspicion (PDF 199KB)
Specific procedure and guidelines for observing supervisors to determine if there is reasonable suspicion that an employee is under the influence of alcohol and/or drugs in the workplace.
A comprehensive checklist to be completed by an observing supervisor detailing specific physical and verbal indicators of an employee under the influence of alcohol and/or drugs. Checklist is to be submitted to Employee Labor and Relations as soon as possible.
Submitted by: Observing Supervisor
Incident Report-Employee (PDF 155MB)
Completed by injured/ill employee and submitted to Employee & Labor Relations as soon as possible after incident.
Submitted by: Employee
Incident Report-Supervisor (PDF 1.12MB)
Completed by on-duty Supervisor of injured/ill employee and submitted to Employee & Labor Relations as soon as possible after incident.
Submitted by: On-duty Supervisor
Incident Report-Witness (PDF 1.48MB)
Completed by any witness to the incident and submitted to Employee & Labor Relations as soon as possible after incident.
Submitted by witness(es) to incident
Dispute Resolution (PDF 8KB)
Request a job audit for reclassification of current position. If approved, reclassification will be retroactive to date of submission.
Submitted by: Employee and/or Supervisor
Approval: Employee, Supervisor
Reprimand Letter (docx 18KB)
At times, a manager can be faced with disciplining an employee for a performance or attendance issue. This template should be used to discipline and correct employee performance or attendance issues. This is discipline. This template has two drop-down boxes which make it applicable in most circumstances. The first drop-down box lets the manager choose between an oral or written reprimand. The second drop-down box permits the manager to choose the type of violation or concern from a series of choices.
FMLA Request (PDF 105KB)
To be completed by the employee 30 days prior to the leave or 15 days after the leave has begun for a serious illness or injury of the employee or employee's family member. Employee must also have the health care provider complete and submit the appropriate FMLA form.
Family Medical Leave for Employee (PDF 155KB)
(FMLA WH380E)
To be completed by HR and employee's health care provider 30 days prior to the leave or 15 days after the leave has begun for a serious illness or injury of the employee.
Submitted by: Employee
Approval: Employee Labor Relations
Family Medical Leave for Family Member (PDF 135KB)
(FMLA WH380F)
To be completed by HR and family member's health care provider 30 days prior to the leave or 15 days after the leave has begun for a serious illness or injury of a family member.
Submitted by: Employee
Approval: Employee Labor Relations
Parental Leave Request (PDF 537KB)
To be completed by the employee at least 30 days prior to the requested leave. Employee must also have the health care provider complete and submit the appropriate FMLA form.