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SUNY Upstate Medical university Human Resources

Human Resources Forms

Documents are in Adobe PDF format unless otherwise noted.

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Employee Separation Forms

Payroll Forms

Employee Benefit Forms (State)

Health Insurance

  • Health Insurance Transaction Form (PS-404) Interactive form
  • Davis Vision, Direct Reimbursement Claim Form
  • Laser Vision Correction, Direct Reimbursement Claim Form (UUP Employees Only)
  • CIGNA Claim Form
  • UUP Benefit Trust Fund Scholarship Application
  • UUP Benefit Trust Fund Application (Student Verification Form)
  • Health Insurance Websites:

    Leaves

  • Employee Leave Certification (Employee's Illness or Injury) Interactive form
  • Employee Leave Certification (Employee's Seriously Ill Family Member) Interactive form
  • Request For Leave of Absence Interactive form
  • Leave Donation Form  WORD document
  • Other Forms

  • Injury Report Form - State
  • UUP Benefits Forms
  • Salary Reduction Agreement
  • Physical Job Requirements Checklist  WORD document
  • Productivity Enhancement Program (PEP) Plan Description and Enrollment Form (CSEA and M/C)
  • Employee Benefit Forms (Research Foundation)

    Health Insurance

  • Reseach Foundation Open Enrollment Form
  • Research Foundation MVP Enrollment Form
  • Research Foundation HMO-Blue Enrollment Form
  • Davis Vision, Direct Reimbursement Claim Form
  • Delta Dental Claim Form
  • Empire Plan Helpful Hints WORD document
  • Health Insurance Websites:

    Leaves

    Other Forms

    Recruitment Forms

    Classification and Compensation Forms

    Performance Program and Evaluation Forms  WORD document

    CSEA

    PEF

    Management Confidential (M/C)

    Research Foundation

    UUP

     


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