The contents of this page are intended for the use of current Washington County Employees. All materials are subject to change without notification.

Forms

• Authorization for Criminal Record Check
• Bereavement Leave Request Form
• Change of Address Packet
• Compliance Confirmation Form-Child Protection
• Dental Dependent Certification Form
• Dental Enrollment Form
• Dental Enrollment/Change Form - Buy-up Plan (Salaried Employees and Elected Officials Only)
• Direct Deposit Form
• Discrimination Complaint Form
• Flexible Spending Account Form (TASC)
• Flexible Spending Account Summary Plan Description
• FMLA (Family & Medical Leave Act) Employee's Guide to FMLA
• FMLA (Family & Medical Leave Act) Employee Rights
• FMLA (Family & Medical Leave Act) Who to Contact
• ID Badge Form
• Job Bid Form
• Life Insurance Beneficiary Change Form
• Medical Insurance Enroll Form
• Medical Insurance Enroll Form - Performance Blue (Salaried Employees and Elected Officials Only)
• Medical Insurance Change Form
• Medical Insurance Change Form - Performance Blue (Salaried Employees and Elected Officials Only)
• Non-Tobacco User Certification Form
• Opt Out Incentive Enrollment Form
• Personnel Requisition Form
• Preferred Method of Contact Form
• Provisional Application-Child Protection
• Retirement Change in Member Contribution Rate
• Retirement Member Designation of Beneficiary
• Voya Participation Agreement-Contribution Deduction Form
• Voya Beneficiary Designation Form
• Voya Unforseeable Emergency Withdrawal Request
• W-4 Form
• Workers Comp Injury Claims Packet
• Workers Compensation Information
• Workers Comp Flow Chart