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Employee Forms
COVID-19 Related Information
Emergency Sick Leave Request Form
COVID-19 Response Policy
Pandemic Response Policy
How to connect to Virtual Visits by Teladoc
Employee Rights (English) - Families First Coronavirus Response Act
Employee Rights (Spanish) - Families First Coronavirus Response Act
City of Burleson - Webinar Pandemic/COVID Presentation
City of Burleson - (English) Printout Pandemic/COVID Presentation
City of Burleson - (Spanish) Printout Pandemic/COVID Presentation
Family First Coronavirus Act - (English) Summary Matrix
Family First Coronavirus Act - (Spanish) Summary Matrix
AWP COVID-19 Webinar Presentation
AWP COVID-19 Printout Presentation
Symetra COVID-19 Resource Material
Standard Employee Documents
Wellness Reimbursement Form
2020 Payday Holiday Calendar
90 Day New Employee Evaluation Survey
Alert System Everbridge Enrollment Form
Direct Deposit Form
Emergency Contact Info Form
Employee of Quarter Nomination Form
Employee Time Sheet (1 Week, No Mileage)
Employee Time Sheet 9/80 (1 Week, No Mileage)
Employee Time Sheet (Police - 2 Weeks)
Employee Time Sheet (With Tips)
Exempt Employee Leave Report
FML Doctor’s Note - Employee
FML Doctor’s Note - Family
HSA Contribution Options Form
Longevity Election Change Form
Longevity Election Form
Sick Leave Calculation
TMRS Change Address Form
Tuition Reimbursement Form - Before
Tuition Reimbursement Form - After
United Way Contribution Form
Wellness Form 2020
W-4 2020 Form
First Report Of Injury CareNow
First Report Of Injury Concentra
- COB Worker’s Comp Information for Concentra Virtual Visit
- COB Supervisor Authorization Form for Concentra
- Concentra Virtual Visits Instructions ~ English
- Concentra Virtual Visits Instructions ~ Spanish
First Report Of Injury No Doctor
First Report Of Injury Huguley
First Report Of Injury THR
Open Enrollment Meetings Date/Time
2020 COBRA Retiree Benefits Guide
2020 Benefits Changes
2020 Benefits Guide
2020 Spanish Benefits Changes
2020 Spanish Benefits Guide
2020 Expanded Preventive Prescription List
2020 Prescription Drug List
How to connect to Virtual Visits by Teladoc
Bentek Enrollment Link
Compass Webinar Link (Google Chrome browser needed)
2020 UHC HD-HSA Plan Summary of Plan Description (Detailed Summary)
2020 UHC HD-HSA Plan Summary of Benefits and Coverage
2020 UHC Copay-GAP Plan Summary of Plan Description (Detailed Summary)
2020 UHC Copay-GAP Plan Summary of Benefits and Coverage
GAP Presentation Recording
GAP-Presentation-Slides
UHC - Dental Summary of Benefits
UHC - Vision Summary of Benefits
UHC - Vision Certificate of Coverage
UHC - Vision Group Policy
Annual Notices - Fall 2019 through Plan Year 2020
Compass Flyer
LapCorp - Lab Network Provider
UHC Contact List
UHC Cost Estimator
UHC Find A Network Doctor
UHC Finding The Right Care Center
UHC Health Discount Program
UHC Health4Me App
UHC Virtual Visits
UHC Vision Plan
UHC Preventive Care Guidelines Flyer
Beneficiary Companion Flyer
Health Companion Flyer
Identity Theft Protection Flyer
Travel Assistance FAQ
Travel Assistance Program Flyer