Employee/Employer Forms
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DMA 5.3-1-R & 5.3-2-R — Authorization for Release of Health Care Information
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DMA 5.3-R — Occupational Health Medical History Form
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DMA 8 — Authorization For Disclosure or Exchange of Confidential Medical Records
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DMA 23-E — Request for Approval of Outside Employment
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DMA 38-E — DMA State Training Traveling Request/Authorization
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DMA 172 — JFHQ-WI Facility Access Request EAL (xlsx download)
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DMA 3000 – Policy Acknowledgement
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DMA 3100 – Hiring Justification
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DMA 3101 – Off-boarding, Recruiting and New Hire Process Checklist
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DMA 3102 – Requirements for Posting a Position
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DMA-3105 – Reclassification Justification
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DMA 3200 – Retirement/Resignation Notice
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DMA 3250 – Military Leave of Absence Request (Exceeds 30 days)
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DMA 3401 – Supplemental Pay Request for Exempt Employees
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DMA 3501 – Security Officer Physical Readiness Test Record of Results
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DMA 3502 – Fire Crash Rescue Specialist Physical Agility Assessment Record of Results
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DMA 4100 — DMA Form Request
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DMA 9006 – Single Source Identification Card (SSID) and Facility Access Request.
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DOA 15100 – Veterans New Hire Information
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DOA 15302 – Position Description
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DOA 15104 – Reasonable Accommodation Request Form
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DOA 15308 – Leave Without Pay (LWOP) Request/Authorization
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DOA 15330 – Justification for Discretionary Merit, Equity or Retention Award (DMC/DERA)
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DOA 15336 – Fitness For Duty Certification – Return To Work Release
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DOA-15519 – Limited Term Employment Acknowledgment
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DOA 15802 – Adverse Employment Action Employee Grievance
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DOA 15805 – Condition of Employment – Employee Grievance Report
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DMA Form – Self-Reporting Derogatory Information
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Policy Template
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USCIS I-9 Form Employment Eligibility Verification
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Voluntary Self-Identification of Disability (CC-305)
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WRS Additional Contributions Election Form
Workers Compensation Forms
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DOA 6058 — Employee Workplace Injury or Illness Report
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DOA 6437 — Supv & Safety Coord Investigation Report for Injury or Illness
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DOA 15336 — Fitness For Duty Certification – Return To Work Release
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Employee Workplace Injury or Illness Report Guidelines
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WKC 12 E — Employer’s First Report of Injury or Disease
Family and Medical Leave Act (FMLA)
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Family and Medical Leave Act (FMLA) Portal
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DOA 15336 Fitness For Duty Certification – Return To Work Release
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DOL WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition
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DOL WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition
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DOA 15322 — FAMILY AND MEDICAL LEAVE (FMLA) REQUEST
