Employee Separation Forms:

Clearance Form
Exit Interview
Separation Summary

Flex Benefits Forms:

Cafeteria Plan
Dependent Care Enrollment/Status Change
Dependent Care Reimbursement Forms:   (.pdf )
      -  Health Care Reimbursement
      -  Dependent Care Reimbursement

Long-Term Disability:

form for LSUHSC-S Employee
form for treating Physician

Worker's Compensation Forms:

Employer Report of Injury/Illness   (.doc)   (.pdf)
Incident/Accident Investigation
On-the-Job Injury                         (policy &  forms)

Tuition Exemption Form

© Human Resource Management
LSUHSC-S, Shreveport, LA

Last Update: June, 2009