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Larimer County Administrative Services, District Attorney, Courts, Ranch, and Landfill will be closed on December 25, 2024, to celebrate the Christmas Day holiday.
Critical county services are not disrupted by closures.

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Human Resources

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Human Resources
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HR Forms

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BENEFITS FORMS

Application for Donated Sick Leave (LCHR-125)
Benefit Status Change Form (LCHR-52)
Common Law Marriage Affidavit (LCHR-80)
Medical Leave of Absence Request (LCHR-60)

COMPENSATION & CLASSIFICATION FORMS

Acknowledgment of Appointed Employee Status (LCHR-119)
Consent & Waiver for Changes from Appointed to Regular or Limited-Term Employment (LCHR-39)
Consent & Waiver for Changes from Regular or Limited-Term to Appointed Employment (LCHR-40)
Guiding Principles Cash Bonus Request (LCHR-46)
Limited-Term Employee Acknowledgement Form (LCHR-84)
Position Description Questionnaire

FMLA FORMS

All FMLA forms can be found on this page.

GENERAL HR FORMS

Administrative Leave Request Form (LCHR-66)
Collective Bargaining Personal Information Opt-Out Form
Employee Separating Checklist
Exiting Employee Checklist (LCHR-3)
New Employee Checklist (LCHR-5)
Reasonable Suspicion Checklist (LCHR-127)
Remote Work Application (LCHR-70)
Request to Retain Vacation Leave (LCHR-67)
Suggestion Form - Available via the Bulletin Board
Waiver of Temporary Posting (LCHR-69)

HIPAA FORMS

Authorization for Use and Release of Protected Health Information (LCHR-93)
Business Associate Agreement (LCHR-96)
Comprehensive Notice of Privacy Policy and Procedures (LCHR-104)
Employee Confidentiality Agreement (LCHR-95)
Notice of Information Practices (LCHR-92)
Request Not to Use or Disclose Protected Health Information (LCHR-100)
Request to Correct or Amend Record (LCHR-98)
Request to Inspect and/or Copy Protected Health Information (LCHR-94)
Response to Amendment or Correction Request (LCHR-99)
Response to Inspection Request (LCHR-97)
Response to Request Not to Use or Disclose Protected Health Information (LCHR-101)

PAYROLL FORMS

New Employee Checklist (LCHR-5)
Civic Center Parking Structure Permit Form
Compensatory Time Off Agreement (LCHR-75)
Connectivity Allowance Form (LCHR-12)
Guiding Principles Cash Bonus Request (LCHR-46)
Non-Cash Bonus or Award Form (LCHR-9)
Out-of-Title Authorization Form
Out-of-Title Payroll Submission Form
Paycard Enrollment Form (LCHR-129)
Payroll Advance (LCHR-13)
Retro Pay (LCHR-89)

WELLNESS FORMS

Biometrics Navigate Physician & Reasonable Alternative Form
Biometrics Pregnancy Alternative Request Form
Biometrics Program Appeal Form
- Program Appeal Application
Biometrics Program Alternative Waiver Form
Extra Wellness Activity or Campaign Submission Form

Human Resources Department

HOURS: Monday - Friday, 8:00am-4:30pm

200 West Oak, Suite 3200, Fort Collins, CO 80521
PO Box 1190, Fort Collins, CO 80522
PHONE: (970) 498-5970 | FAX: (970) 498-5980
Email Human Resources
Email Benefits Team