Quick Find
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
The following forms are listed alphabetically and may be downloaded, filled out and sent to the appropiate office:
Note: The forms listed on this page are PDF. Acrobat Reader (4.0) is required in order to view PDF files.
A
- Address Change (change your address and emergency information in JList)
- Administrative Manual
- Affirmative Action Statement
- Affirmative Action Information Form
- Affirmative Action Form for Veteran Status
- Anthem Customer Claim Form
- Anthem Enrollment Form
- Anthem Information
- Anthem General Mail Order Form (For KeyCare, BlueCare & HealthKeepers)
- Anthem HealthKeepers Vision Claim Form
- Anthem Member Change Form
- Anthem Vision Services Claim Form (For KeyCare & BlueCare)
- Application for Posted Job Vacancy (HR Form 101.00)
- Appraisal Information
B
C
- Check Disbursement Form
- CIGNA Beneficiary Designation Form
- CIGNA Beneficiary Designation Form
- CIGNA Evidence of Insurability Form
- CIGNA Life Insurance Claim Form
- COBRA
- Compensation
- Conflict of Interest Information
- Contact List
D
- Delta Dental Change Form
- Delta Dental Claim/Pre-Authorization Form
- Dental Insurance
- Direct Deposit Authorization
E
- Educational Reimbursement Program (formerly TAP)
- Educational Reimbursement Program (formerly TAP) Application ( .pdf) (HR Form 302.00)
- Educational Reimbursement Request ( .pdf) (HR Form 301.00)
- Employee Assistance Program (EAP)
- Employee Relations
- Employee Relations Forms
- Employee's Virginia Income Tax Withholding Exemption (Form VA-4)
- Employee's Withholding Allowance Certificate (Form W-4)
- JLab Employment Application
- Employment Interviewee Evaluation (HR Form 102.00)
- Employment Opportunities
- Equal Employment Opportunity/Affirmative Action Statement
- Employment Forms
- Exit Interview Form (HR Form 405.00)
F
- Family and Medical Leave Request Form
- Federal Income Tax Withholding Allowance Certificate (Form W-4)
- Flexible Spending Account Direct Deposit Form
- Flexible Spending Account Enrollment Form
- Flexible Spending Account Reimbursement Request Form
- FMLA
- Forms by Department
G
H
J
- Job Hot Line
- Job Related Training Request (HR Form 303)
L
M
O
- Occupational Health & Safety
- Online Forms by Department
- Optima Change Form
- Optima Information
- Optima Prescription Home Delivery Order Form
P
- Performance Appraisal Forms (HR Forms 400, 402)
- Performance Rating Standards
- Personal Information Form (HR Form 202.01)
- Position Description (pdf, doc) (HR Form 207.00)
- Prescription Home Delivery Order Form (For Optima)
R
- Radiological Worker Training Guide
- Radiation Worker I proficiency test
- Recommendation to Hire (pdf, doc) (HR Form 103.00)
- Request to Engage in Outside Business Activities Form (HR Form 404)
- Retirement Plan Summary - SURA-JSA Defined Contribution
- Retirement Plan 2006 - SURA-JSA Defined Contribution
S
- Salary Ranges
- Sexual Harassment Policy
- Short-Term Disability Insurance (STD)
- Staff Development & Training
- Student Evaluation Form (pdf, doc)
- Student Internship Program
- Substance Abuse Policy
- Supplemental Life Insurance
- Supplemental Retirement Annuity (SRA) Action Form
- JSA Employment Interviewee Evaluation
- JSA Recommendation to Hire (HR Form 103)
T
- TIAA-CREF Authorization to Change Address (HR Form 204.00)
- TIAA-CREF Group Supplemental Retirement Annuity Enrollment
- TIAA-CREF Information
- TIAA-CREF Notice of Change of Name
- Training Forms
V
- Virginia Income Tax Withholding Exemption (Form VA-4)