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HR Forms Library

This section is devoted to any forms the Department of Human Resources may provide the UTMB campus.  

These forms (where applicable) will allow you to type information in and print out immediately. Or you may print the form out to fill out at your leisure. We will be adding forms in the future.  If you need a form that is not on this list, please contact your departmental Human Resources Consultant. 

Employee-Related Forms

Leave Request
Tuition Reimbursement
Career Interest Worksheet
New Employee Packet
Sample Notice of Resignation
Exit Checklist
Exit Interview Questionnaire
Dual Employment
Benefit Exit Information

Employee Health Clinic Forms

Initial Health Questionnaire
Employee Foreign Travel Form
TB Skin Test Form
TB Evaluation Form
TB Certificate – For CMC Use Only
N-95 Medical Questionnaire
Respiratory Questionnaire
Research Initial Questionnaire
Annual Research Questionnaire
Immunization Requirements for Annual Research Questionnaire

Telecommuting Forms

Telecommuting Form
Telecommuting Justification
Home Office Safety
Keys to Success

Departmental Related

Adverse Events Toolkit
JCAHO Checklist
Selection Packet
Without Salary Appointment Checklist
New Hire Packet for WOS
Job Description Template, A&P
Job Description Template, Classified

Employee and Departmental Related

Emergency Preparedness Employee Acknowledgement Form – UTMB
Emergency Preparedness Employee Acknowledgement Form – CMC
Employment Eligibility Verification
Performance Management Coaching Document
Employee Guide

Employee Performance Reviews

UTMB Performance Management Web Page

Sick Leave Pool

Request for Sick Leave Pool – Employee Application
Request for Sick Leave Pool – Health Care Provider Certification

Job Questionnaire for Reclassification

Job Analysis Questionnaire, Classified
Job Analysis Questionnaire, A&P

Family and Medical Leave Act Forms

Leave of Absence Request Under FMLA – Employee Statement
Leave of Absence Request Under FMLA – Health Care Provider Certification
Leave of Absence Request Under FMLA – Employee Statement and Health Care Provider Certification (Combined)
Qualifying Exigency for Military Family Leave Form
Serious Injury or Illness of Covered Servicemember Form

Employee Injury/Illness Management Related Forms

Employee Injury Report Form
Ergonomic Worksite Evaluation
Request for Temporary Job Modification
Request for Permanent Job Accommodation
Physician's Work Certification


Payroll Related forms
Non Disclosure Forms
TDCJ Access / Clearance

Helpful Links

Contact HR:
Phone: (409)772-8699