Human Resources Forms

Employment

Additional Assignment Authorization Form Performance Appraisal Forms and Guidelines
Conflict of Interest Disclosure Form Staff Telecommuting Agreement
Employment of Relatives Disclosure Form Special Affiliate Request Form

Benefits

General:

Anthem Blue Cross:

Dental/Vision:
Childcare Subsidy Form Home Delivery Pharmacy Booklet Delta Dental Claim Form
CIGNA Life and Accident Insurance Application Home Delivery Pharmacy Order Form Delta Dental Benefit Highlights
CIGNA Beneficiary Form Prescription Claim Form Delta Dental Summary Plan
Lactation Accommodation Request Form Member Claim Form VSP Benefit Highlights
Leave of Absence (LOA) Request Form   VSP Summary of Benefits

Retirement:

USFFA:

Financial Advisor Reimbursement Form

 Rent Reimbursement Request Form

Fidelity Incoming Rollover Form

 Relocation Reimbursement Request Form
TIAA 403(b) Incoming Rollover Form USFFA Second Mortgage Program Description
401(a) Vesting Waiver Form USFFA Second Mortgage Program Application
Emeriti Qualified Medical Expense Form Relocation Assistance Vendor

Tuition:

SF HCSO and SF Sick Leave:
Tuition Remission Form HCSO Employee Voluntary Waiver Form
Tuition Remission Plan

Flexible Spending Accounts:
FACHEX and Tuition Exchange Form BASIC Pacific FSA Reimbursement Claim Form
FACHEX Program - Participating Institutions BASIC Pacific FSA Direct Deposit Form
FACHEX and Tuition Exchange Programs FAQ BASIC Pacific FSA Employee Packet

Commuter:

 BASIC Pacific FSA Welcome Packet
Pre-Tax Commuter Plan and Subsidy Enrollment Form  

Wellness:

Payroll:
GoUSF Event RSVP form All Payroll Forms
Gym Membership Reimbursement Form*  
Wellness Event Reimbursement Form

Workers' Compensation:
Ergonomics Assessment Form Workers' Compensation Benefits
(*for employees not on Hilltop campus) Medical Provider Network (MPN) Notice

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