Human Resources
Forms
Powered by
CAREERS
JOB LIST
FORMS
Departments
Absence Management
Absence Management
The Team
Family Medical Leave Act (FMLA)
Workplace Injury
Forms
Administration
Administration
Email Groups
The Team
Staff Engagement Survey Results
HR Organizational Chart
Benefits
Benefits
The Team
Health & Wellness
Life & Disability
Retirement
Time Away From Work
Additional Benefits
Forms
Compensation
Compensation
The Team
Job Code Table / Job Descriptions
FLSA Overtime Expansion
Advising Career Progressions
Procedures
Salary Determination Tool
Salary Schedule
Total Compensation Calculator
Forms
Employment Services
Employment Services
The Team
Find your Contacts
DMU and New FY Processing (2025)
Hiring
Salary/Wage Ranges
Job Descriptions
Verification of Employment
Veterans
Reduction in Force (RIF) Preference
FAQs
Forms
Employee Relations
Employee Relations
The Team
Programs
Services
Abusive Conduct
Staff Grievance Procedures
Accessing Personnel Files
Telecommuting Guidelines
Career Transition Resource Guide
Dealing with Disruptive & Threatening Behavior
Forms
HR Information Systems
HR Information Systems
The Team
Systems Supported
Payroll
Payroll
The Team
Additional Pay eForm
Kronos
Paycheck Information
Payroll Schedule/Deadlines
Payroll Reporter List
Summer Pay Calculation
Cell Phone Reimbursement
Tax Information
Reallocation
Forms
Solution Center
Solution Center
The Team
Training & Development
Training & Development
The Team
Classes By Category
Classes A - Z
Class Calendar
Bridge Log In
Certificate Programs
UUHA Annuals
Workforce Analytics
Workforce Analytics
The Team
Information Request Form
Forms
Workplace Accommodations
Workplace Accommodations
Disability Access
Pregnancy
Religious
Q&A – Reasonable Accommodations
Forms
Contact Us
Contact Us
Find Your HR Contact
Campus
A-Z Index
Campus Directory
Campus Map
Find Your HR Contact
Forms
Forms
Expand All
Absence Management
Employer's First Report of Injury or Illness (Worker's Comp)
- E1 Form 122
FMLA - Certification of Health Care Provider for Employee
Certifcacion de Proveedor Medico Estado de Salud del Empleado
FMLA - Certification of Health Care Provider for Dependent
Certifcacion de Proveedor Medico Estado de Salud del Familiar
FMLA - Frequently Asked Questions
FMLA - FAQs en espano
FMLA - Intermittent Tracking
Intermittent_Parental Tracking Form
FMLA and Parental Leave Request
Solicitud para FMLA y Ausencia Paternal - Maternidad, Paternidad y Adopcion
FMLA - Release of Information (Family Member)
FMLA - Release of Information (Self)
FMLA - Request for Family and Medical Leave of Absence
Solicitud Para Ausencia bajo la Ley de Ausencia Familiar y Medica
Military Leave of Absence
Request for Non-Health Related Leave of Absence
Benefits
UBenefits Electronic Enrollment and Changes
UBenefits
New Hire Enrollment
Add a Child
Add a Spouse/Partner
Beneficiary Update
Cancel Disability, AD&D or Life Insurance
Change AD&D Coverage
FSA Dependent Care Change
Gain of Other Coverage
HSA Pledge Change
Loss of Other Coverage
Remove a Spouse/Partner
Salary Reduction Agreement - 403(b) Supplemental Retirement Plan
Salary Reduction Agreement - 457(b) Supplemental Retirement Plan
401(a) Provider Change and Salary Reduction Agreements
Tuition Reduction Application
Medical/Dental
Advantage Plan Summary Plan Description
Authorization for Release of Protected Health Information
Certification of Dual Coverage for Coordination of Prescription Benefits
COBRA Notice
Comprehensive Plan Summary Plan Description
Consumer Directed Health Plan Summary Plan Description
Dental Coverage Summary Plan Description
Health Care Student Verification
Health Insurance Marketplace Notice
Health Plan Request for Reimbursement - Blue Cross Blue Shield/ValueCare
Health Plan Request for Reimbursement - University Health Care Plus
Notices - HIPAA Opt Out and CHIP
Prescription Drug Coverage Information/Forms
Privacy Notice
Medicare D Notice of Creditable Coverage
Summary Comparison of Health Plan Medical and Dental Options
Submit Family Member Tax Identification Number
Flexible Spending
Parking FSA Election/Change Form
Parking Reimbursement Request Form
Flexible spending account change form
Life & Disability
Additional Benefits Enrollment
Life Insurance - Personal Health Application
Long Term Disability - Late Enrollment (paper form)
Long Term Disability - Late Enrollment (online form) - Policy 136485
Retirement
Certification of Hardship Withdrawal from Employer 401(a) Contributions
(Employee must be age 59½ or older)
Certification of Hardship Withdrawal from Elective 403(b) Contributions
Certification of Hardship Withdrawal from Elective 457(b) Contributions
University's Annual Universal Availability Notice
Other
ACH Agreement
Benefits Billing
Domestic Partnership Certification
Employer's First Report of Injury or Illness (Worker's Comp)
- E1 Form 122
Extended Sick Leave Benefits
MetLife Legal Plans Certificate of Coverage
LTC - CNA Enrollment
Preventive Services Under ACA
Reinstatement of Prior Service
Request for Reinstatement of Lost Vacation Accruals
Separating from the University
Travel Assistance Brochure - Life Insurance
Travel Assistance Brochure - Life Insurance
(Spanish)
Vacation Donation
WellU Request for an Alternative Option.
Compensation
Compensatory Time Agreement
Leadworker Employee Questionnaire
Lump Sum Increase
Compensation Request Form
Reclassification Instructions
UCareer Mass Update Request
Employee Relations
Abusive Conduct Reporting Form
Acceptance of Resignation
Request to Examine/Copy Data From Personnel File
Staff Appeal
Employment Services
Abusive Conduct Reporting Form
Affiliate/Non-Employee
Company Consulting Services Agreement
Initiate Background Check and/or Drug Screen
Initiate Drug Screen Only
I-9 Appointment Request Form (traditional HR only)
Certiphi Background Check / Drug Screen Information Letter
Confidentiality and Information Security Agreement
Employee Intellectual Property Assignment Agreement
Employees Return To Campus
Employment Verification Request (Grants and Contracts only)
Employment Verification Request (Past and Present employee use only)
Email I-9 Team
ePAF/D-Jobs/HRIL Security Authorization Form
Hiring Process & Forms/Open Position Information
Hiring Status Planning form
IRS Forms and Instructions
Non-selection Letter
Non-Staff and Volunteer Photo ID Authorization
Non-Staff Workforce & Volunteer ID Badge Information Data Sheet
Offer Letter, Benefited Staff
Offer Letter, Non-Benefited Staff
Out of State Employment Request
Reference Check, Sample Document
Telecommuting Plan and Agreement Form
UUHealth Benefitted Offer Letter
UUHealth NonBenefitted Offer Letter
Veterans' Preference Addendum
Working outside Utah or United States
Workplace Drug and Alcohol Testing Program for Commercial Drivers
Immunization
University Hospital and School of Medicine Patient Care Staff Only.
Payroll
Payroll
Academic Contract Worksheet
Accruals Adjustments, Vacation
Cell Phone Reimbursement
Direct Deposit Help
Direct Deposit Cancellation
Missed Punch/Exception
Paper Timesheet
Retroactive Adjustment (Hospital)
Reallocations
Stale Date Request
Stop Payment
Kronos
Kronos Supervisor Access Request
Kronos Late Sign off
Kronos Senior Administration Accrual Tracking Request
Additional Earnings
Additional Compensation
Additional Compensation for Teaching
Bonus Pay
Clinical Income Payment
Moving Allowance
Payment of Exempt Clinical Shift
Prize and Awards
Training & Development
Onsite Training and Group Facilitation Request
Workforce Analytics
Information Request
Workplace Accommodations
ADA Accommodation Request
Pregnancy Accommodations Request
Religious Accommodation Request
Vaccine Exemption Request
