Benefits Claim Forms
For more information, visit our pages on Sun Life Benefits or University Health Insurance Plan (UHIP).
Sun Life Dental Claim Form
Form for paper-based claim submissions for all dental expenses and services.
Sun Life Extended Health Care Claim Form
Form for paper-based claim submissions for all medical expenses and services.
Payroll and Tax Forms
For more information, visit our Payoll or Tax Information pages.
WEBSITE
Determination of Exemption of an Indian’s Employment Income
2025 Determination of Exemption of an Indian's Employment Income Form
WEBSITE
Supplemental Payment Form
This form is used to facilitate the processing of payments that fall outside the scope of the Mosaic SPP eForm Process.
Life Change Event Forms
For more information, visit our page on Life Events.
WEBSITE
Request for Leave of Absence Form
To request any type of leave of absence, with the exception of Personal Emergency Leave, employees must complete this form and forward to Human Resources Services.
General Forms
HR Event Form
The HR Event Form should be used to submit an employee Temporary Additional Duties or a Temporary Transfer request, or a resignation or retirement request for non-FHS Faculty Members. For all other employee change requests, please submit a Mosaic HR eForm.
WEBSITE
Request for Leave of Absence Form
To request any type of leave of absence, with the exception of Personal Emergency Leave, employees must complete this form and forward to Human Resources Services.
Employment Verification Request Form
Use this form to provide Individual Consent for Disclosure of Personal Information to a Designated Third Party
WEBSITE
Employee Direct Deposit Form
Existing employees will complete this form when requesting modification to their direct deposit information. Employees who are new to the University will complete this form during the hiring process.
Retiree Address Change Notification Form
Form to notify Human Resources Department of updated home address to ensure employee receives correspondence.
Employee Health Services
For more information, visit the Health, Safety & Well-Being pages.
POP-UP
Notification of Medical Leave
Use this form to notify Employee Health Services (EHS) of employee absences due to illness or injury for 10 days or greater.