Benefit Forms

Medical Enrollment Form
Dental Enrollment Form
Vision Enrollment Form
Flexible Spending Account Enrollment Form
Flexible Spending Reimbursement Form
Group Benefits Enrollment Form
Group Benefits Change Form
Health Saving Plan Enrollment Form
Life Evidence of Insurability Form
Salary Deferral Agreement-UA
Retirement TIAA-CREF Beneficiary Change Form
Retirement Fidelity Investments Beneficiary Change Form
Pharmacy Appeal Form
Medical Appeal Form
Catastrophic Leave Form
Catastrophic Physician’s Certification Form
Family Medical Leave Request Form\

New Employee

W-9
J-1 Visa for Visiting Scholars

Payroll Forms

Direct Deposit Authorization Form
Direct Deposit (Secondary) Form
Payroll Deduction Authorization

General Forms

Accommodations Process for Faculty and Staff with Disabilities
Concurrent Employment Form (Internal)
Employee Accommodation Request Form 
Grievance Form
Tuition Waiver Form – Spouse-Dependent

Physician Certification Forms

WH-380-Employee Physician Certification Form FMLA 
WH-380-Family Member Physician Certification Form