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
• OMC Patient History
• Opt Out Incentive Enrollment Form
• Parking Indemnification 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