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Human Resources

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Human Resources
About Human Resources
HR Forms

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