Forms
Job Applications
Public Forms
Employee Only Forms
- Accident-Incident Report Form (PDF)
- Authority to Release Private Information Form (PDF)
- Direct Deposit Authorization Form
- Grievance Form-Complaint Questionnaire (PDF)
- Hours Certification Form for Elected and Exempt Employees (PDF)
- Public Records Exemption Log (PDF)
- Request to Correct or Amend PHI (PDF)
- Revocation of Authorization for Use / Disclosure of PHI (PDF)
- Sick Bank Donation Form
- Sick Leave Conversion Form (PDF)
- Violent Act / Threat Report Form (PDF)
Employment Documents
Orientation Policies and Procedures
- Overseeing Email Internet Policy
- PERSONNEL POLICY SUMMARY 2021
- Notice of Leave Policies
- Privacy Policy
- HIPAA Privacy Notice
- EEO Policy
- 2022-2023 Equal Employment Opportunity Plan
- Work Place Violence policy
- Reporting Workplace Violence
- Smoking Policy
- Maint Drug Free Workplace Policy
- Anti-Harassment Policy
- Employee Paid Sick Leave Notification
- Bloodborne Pathogen Exposure Control Plan
- New Hire Clock In Reference Sheet
- Policy Acknowledgements
- Confidentiality Statement
Orientation - Retirement
Orientation - Health Insurance and Voluntary Benefits
- 02_Exchange_Notice_081513 - Copy
- CHIP Program Notice
- Salary Redirection Agreement
- 01_Important Notice to New Employees
- Teamster Participant Data Form
- Waiver of Medical Coverage
- Group Voluntary Life Insurance
- Group Voluntary Short Term Disability Insurance
- The Standard Group Buy-up Long Term Disability Insurance - Booklet
- The Standard Group Voluntary Accidental Death and Dismemberment Insurance Booklet
- Life Flight application
- WHITMAN COUNTY BENEFIT PHONE NUMBER LIST 2021