HR Forms

Forms are arranged by the following categories:

Benefits Forms
Employee Relations Forms
Employment Forms
Leaving Lehigh Forms
Recognition and Reward Forms
Staff Compensation Forms
Tuition Cash Grant Forms
Wellness Forms
Career Enrichment and Performance Forms
Workplace Posters

Benefit Forms
Benefit Changes (Qualifying Life Events)	Making Changes to Benefits due to a Qualifying Life Event: Log into Lehigh Benefits at https://go.lehigh.edu/benefitfocus Click "View/Edit Your Benefits" on the right side of the screen Enter your changes Upload documentation
Medical Plan Forms	Medical Expense Claim Form Spouse/Partner Surcharge Waiver Request
Dental Plan Claim Form	United Concordia Claim Form
Domestic Partnership Forms	Affidavit of Common Law Marriage - Employee Affidavit of Common Law Marriage - Spouse Affidavit of Domestic Partnership Affidavit of Tax Qualified Dependent Statement of Termination of Partnership Tax Information on Health Benefits for Domestic Partners
Family Medical Leave	Academic Planning Form for Faculty (Provost's Office) Lehigh Faculty and Staff FMLA Request Form Certification of Healthcare Provider Form (for the employee's own serious health condition) Certification of Healthcare Provider Form (for a family member's serious health condition) Healthcare Provider's Release to Return to Work
Flexible Spending Accounts (FSA)	WageWorks FSA Claim Forms WageWorks Healthcare FSA Eligible Expenses WageWorks Childcare Eligible Expenses
Leave Requests for Staff	Leave of Absence Form Paid Parental Leave Request Form
LVAIC Cross Registration Form for Employees and Spouses	LVAIC Cross Registration Form
Mortgage Incentive Program	Home Buying Program Brochure Mortgage Payment Form Promissory Note
Personal Information Changes (changes in name, address, phone number, emergency contact, or marital status)	Personal Information Change Form (Docusign Form) OneCard Maintenance Form (Use for name changes on OneCard)
Prescription Plan Forms	Express Scripts Mail Order Form Express Scripts Request a New Prescription Form Express Scripts Coordination of Benefits/Direct Claim Form
Short Term Disability Plan Forms	Short Term Disability Claims Procedure Short Term Disability Employee Checklist Healthcare Provider's Release to Return to Work
Tuition Cash Grant	Tuition Cash Grant Application (pdf) Tuition Cash Grant Application via DocuSign Tuition Cash Grant Fact Sheet (pdf) Statement of Dependency Form (pdf)
Vision Plan Forms	Davis Vision Claim Form
Voya Voluntary Benefits Claim Forms	Voya Employee Benefits Resource Center
Employee Relations Forms
Accommodation Request	Request for Reasonable Accommodation via the Accommodate system (Includes request for parking accommodation) Medical Information Request and Verification Form Accommodate system login page
Flextime Guidelines	Flextime Guidelines document
Employment Forms
Employment Applications (apply for positions through our online system)	Online Application System
Employment Eligibility Verification (I-9)	I-9 Form
Leaving Lehigh Forms
Staff Separation Forms	Request for Reference And Release Employee's Separation Information Sheet Supervisor's Separation Plan Checklist Personnel Information Change Form (Docusign)
Exit Interview Questionnaires	Employees Transferring Within Lehigh Employees Leaving Lehigh
Recognition and Reward Forms
Spot Bonus Award	Nomination Form (word)
Tradition of Excellence Award	Tradition of Excellence Nomination Form (pdf)
Staff Compensation Forms
Extra Duty Compensation	Extra Duty Compensation Request Form (login required)
On-Campus Consulting/Additional Compensation for Exempt Employees	On-Campus Consulting/Additional Compensation for Exempt Employees Request Form (login required)
Position Descriptions	How to access your position description
Request for Deferred Pay Exception	Staff Request to Abstain from Deferred Pay Program
Temporary Bonus Request	Temporary Bonus Request Form (login required)
Wellness Forms
BeWell	Lehigh University's BeWell platform is designed to support employees in their journey towards holistic wellness, encompassing physical, mental, and emotional health.
CAREER ENRICHMENT and Performance Forms
BEST Program	BEST Program Registration Form (word) BEST Program Registration Form (pdf)
Performance Management	Read about the Performance Management Process
Career Enrichment @ Lehigh (CE@L) Programs	Learn about Career Enrichment @ Lehigh Register for CE@L Programs View the CE@L Calendar Download the Career Enrichment Playbook
Workplace Posters - Federal and State Labor Laws
Federal Workplace Labor Law Posters	Equal Employment Opportunity Fair Labor Standards Act Family Medical Leave Act Government Contracts OSHA Job Safety and Health Polygraph Protection Uniformed Services Employment Rights
State Posters for Pennsylvania	Child Labor Laws (Employment of Minors) Equal Pay Law Human Relations Act Minimum Wage Law Unemployment Compensation Notice