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Employee/Employer Forms

* Fillable PDF - Use IE browser or right click and save to desktop
DMA 002  State Active Duty Pay Authorization  PDF file *
DMA 5.3-1-R & 5.3-2-R  Authorization for Release of Health Care Information  PDF file *
DMA 5.3-R  Occupational Health Medical History Form  PDF file *
DMA 5.3-3-R  Military Affairs Security Officer/Supervisor (MASO) Physical Agility Test PDF file *
DMA 8  Authorization For Disclosure or Exchange of Confidential Medical Records PDF file
DMA 12-E-R  Position Action RequestPDF file *
DMA 23-E  Request for Approval of Outside EmploymentPDF file
DMA 35  DMA State Employee Performance Evaluation PDF file
DMA 38-E  DMA State Training Traveling Request/Authorization PDF file
DMA 39  Request for FLSA Exempt OverTime PDF file
DMA 100  Business Card Request PDF file
DMA 120  Request for Electronic Access Key (EAK) & Facility Access PDF file
DMA 217  Disability Self-Identification  PDF file
DOA 6125  Physicians Certification pdf doc
DOA 15802  Adverse Employment Action Employee GrievancePDF file
DOA 15805  Condition of Employment - Employee Grievance ReportPDF file
DOA 15104  Reasonable Accommodation Request Form pdf file
DOA 15308  Leave Without Pay (LWOP) Request/Authorization word doc
DOA 15330 Justification for Discretionary Merit, Equity or Retention Award (DMC/DERA) doc
DOA 15302  Position Description URL
USCIS I-9 Form  Employment Eligibility Verification pdf file

Workers Compensation Forms

DOA-6058 Employee Workplace Injury or Illness Report PDF file
Employee Workplace Injury or Illness Report GuidelinesPDF file
DOA-6437 Supv & Safety Coord Investigation Report for Injury or IllnessPDF file
WKC-12-E Employer's First Report of Injury or Disease PDF file

Family Medical Leave Forms (FMLA)

DOL WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition
DOL WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition
DCLR-201 Family and Medical Leave - Employee Request

DMA_Icon  State HR Menu

DMA_Icon  State Human Resources

Email
Phone
(608) 242-3153
Location
2400 Wright Street
Madison, Wisconsin
Mailing Address
Department of Military Affairs
WING-SHR
P.O. Box 14587
Madison, WI 53708-0587
AA Officer
Director, State Human Resources,
Department of Military Affairs
WORK: (608)242-3163
FAX: (608) 242-3168
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