Frequently Accessed Forms

Employee-Related Forms

Leave Request
Non-Disclosure Forms
Dual Employment
TDCJ Access/Clearance
Exit Checklist
Exit Feedback Questionnaire

Department-Related Forms

Adverse Events Toolkit
Emergency Classification and Acknowledgement Form (For all employees; click here for helpful FAQs)
Fitness for Duty – Observation Report
JCAHO Checklist
Without Salary Appointment Checklist
Job Description Template – A&P
Job Description Template – Classified
Job Analysis Questionnaire – A&P
Job Analysis Questionnaire – Classified
Contractor Order Form

Employee Health Requirements and Forms

Immunization Requirements
Initial Health Questionnaire
Respiratory Questionnaire
Influenza Vaccine Declination
Hepatitis B Declination
Foreign Travel Form
TB Skin Test Form
TB Evaluation Form
TB Certificate – For CMC Only
N-95 and PAPR Medical Questionnaire
Annual Research Questionnaire
FAQs with Research Questionnaire
Immunization Requirements for Research Questionnaire
Bloodborne Pathogen Exposure Notification and Management Form
Contaminated Sharps Injury Reporting Form
Occupational Bloodborne Pathogen Exposure Process

Injury/Illness-Related Forms

Instructions and Forms for Reporting a Work-Related Injury or Illness
Ergonomic Worksite Evaluation Request
Temporary Job Modification Request
Permanent Job Accomodation Request
Physician's Work Certification
ADA Consent for the Release of Confidential Information

Leave-Related Forms

Application for LOA Request Under FMLA – Employee Statement and Health Care Provider Certification
Application for LOA Request Under FMLA – Qualifying Exigency for Military Family Leave
Application for LOA Request Under FMLA – Serious Injury/Illness of Covered Servicemember
Application for Sick Leave Pool
Direct Sick Leave Donation Form

Telecommuting Forms

Telecommuting Form
Telecommuting Justification
Home Office Safety


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