Skip to Main Content

Create an Account - Increase your productivity, customize your experience, and engage in information you care about.   

  • Sign In

Click to home

  1. Departments
  2. Government
  3. Residents
  4. Services
  5. How Do I…?
Search
  1. Home
  2. Departments
  3. Human Resources
  4. HR Self Service
  5. Forms

Forms

The contents of this page are intended for the use of current Washington County Employees. All materials are subject to change without notification.

Forms



  • Authorization for Criminal Record Check
  • Bereavement Leave Request Form
  • Change of Address Package
  • Compliance Confirmation Form-Child Protection
  • Dental Dependent Certification Form
  • Dental Enrollment Form
  • Direct Deposit Form
  • Discrimination Complaint Form
  • Flexible Spending Account Form (TASC)
  • Flexible Spending Account Summary Plan Description
  • FMLA (Family & Medical Leave Act) Employee's Guide to FMLA
  • FMLA (Family & Medical Leave Act) Employee Rights
  • FMLA (Family & Medical Leave Act) Who to Contact
  • I-9 Form (Employment Eligibility Verification)
  • ID Badge Form
  • Job Bid Form
  • Life Insurance Beneficiary Change Form
  • Medical Insurance Change Form
  • Opt Out Incentive Enrollment Form
  • Personnel Requisition Form
  • Pledge of Confidentiality
  • Provisional Application-Child Protection
  • Retirement Change in Member Contribution Rate
  • Retirement Member Designation of Beneficiary
  • Voya Participation Agreement-Contribution Deduction Form
  • Voya Beneficiary Designation Form
  • Voya Unforseeable Emergency Withdrawal Request
  • W-4 Form
  • Workers Comp Injury Claims Packet
  • Workers Compensation Information
  • Workers Comp Flow Chart




  1. Benefits
  2. Employee Access Center
  3. Forms
  4. Policies
Online Payments
Notify Me®
Report A Concern
Employment
Tax Inquiries
Agendas & Minutes
  1. City Logo

Site Tools

  1. Home
  2. My Account
  3. Printer Friendly
  4. Email Page
  5. Contact Us
  6. Hear This Page
  7. RSS
  8. Site Map
  9. Translate Page
  10. Notifications
  11. Documents
  12. Help

Share

  1. Facebook
  2. Twitter
  3. Pinterest
  4. Delicious
  5. Blogger
  6. LinkedIn

Contact Us

  1. Washington County
    100 W. Beau Street
    Washington, PA 15301

    Phone: 724-228-6700
    Email Us

FAQs

  1. Help! I'm having a Mental Health Crisis! Who Do I call?
  2. Where can I go to get help with substance abuse problems?
  3. Is there a mental health treatment center that can help children or adolescents nearby?
  4. How do I file a request for Open Records?
/FAQ.aspx

Quick Links

  1. Court of Common Pleas of Washington County, Pennsylvania
  2. WashArts
  3. Washington County Chamber of Commerce
  4. Washington County Fair
/QuickLinks.aspx

Quick Links

  1. Home
  2. Open Enrollment
  3. Accessibility
  4. Privacy
  5. Copyright Notices
  6. Contact Us
/QuickLinks.aspx
Arrow Left Arrow Right
[]
Slideshow Left Arrow Slideshow Right Arrow