Most of the forms provided here are in Adobe Portable Document Format (PDF). You must install Adobe Acrobat Reader before you can print these forms. To use our fill-in forms, you must install Adobe Acrobat Reader version 4.0 or greater. Acrobat Reader is downloadable for free. You can also obtain these forms from Human Resource Services at 390 Administration Building or by calling (631) 632-6161.


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Form NameForm ID
Multiple documents IconAccident Reporting System (ARS) ProceduresHRSD0001
Multiple documents IconAttendance and Leave Accrual Report - M/C & UUP FLSA Non-Exempt Employees (FLSA Non-Exempt Time Sheet)303NE
Multiple documents IconFMLA Leave Request FormHRSF0003
Multiple documents IconFMLA RightsHRSD0076
Multiple documents IconFMLA WH-380-E Certification of Healthcare Provider (For employee's own serious health condition)WH-380-E
Multiple documents IconFMLA WH-380-F Certification of Healthcare Provider (For employee's family member's health condition)WH-380-F
Multiple documents IconFMLA WH-384 Certification of Qualifying ExigencyWH-384
Multiple documents IconFMLA WH-385 Certification for Serious Injury or Illness of Covered ServicememberWH-385
Multiple documents IconGraduate Student Employee Attendance ReportSUSB0381
Multiple documents IconLeave Donation Program - Classified Employee Recipient ApplicationHRSF0037
Multiple documents IconLeave Donation Program - DonorHRSF0038
Multiple documents IconLeave Donation Program - Professional Employee Recipient ApplicationHRSF0036
Multiple documents IconMedical Leaves Request FormHRSF0112
Multiple documents IconProfessional Staff Individual Report of AttendanceSUSB0303
Multiple documents IconTime & Attendance Guidelines - State Classified EmployeesHRSD0021
Multiple documents IconTime & Attendance Guidelines - State Professional & Faculty EmployeesHRSD0022
Multiple documents IconUniversity Leaves for Childcare, Child Birth, Adoption - State Classified EmployeesHRSD0004
Multiple documents IconUniversity Leaves for Childcare, Child Birth, Adoption - State Professional & Faculty EmployeesHRSD0002
Multiple documents IconWaiver of Additional Money for Holidays WorkedHRSF0021
Multiple documents IconWorkers' Compensation ProcedureHRSD0024
Multiple documents IconWorkers' Compensation/State Employee Injury/Illness Incident ReportSUSB3019

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