Not all forms are available online. If you do not see the form you are looking for please contact human resources and a paper form can be sent to you via campus mail.
Benefit Forms
Flex Benefits
Benefit Strategies FSA Direct Deposit Form (PDF)
Benefit Strategies FSA Enrollment Form (PDF)
Benefit Strategies FSA Reimbursement Form (PDF)
Health & Dental Insurance
Harvard Pilgrim Enrollment Form (PDF)
Delta Dental Enrollment Form (PDF)
Dependent Eligibility Form (PDF)
Harvard Pilgrim Mail Order Prescription Form (PDF)
Life Insurance
Life Insurance Enrollment and Beneficiary Form (PDF)
Transit Reimbursement
Transit Reimbursement Form (PDF)
Benefit Leave Forms
Request for Leave: Adoption (PDF)
Request for Leave: Family (PDF)
Request for Leave: FMLA (PDF)
Request for Leave: Parental (PDF)
Staff Affidavit for Parental Leave (PDF)
Request for Leave: SNLA (PDF)
Request for Leave: Without Pay (PDF)
Medical Leave Forms
Medical Leave Application (PDF)
Physician's Approval to Return to Work (PDF)
Physician's Statement (PDF)
Employment Forms
Casual Worker Questionnaire (PDF)
Equal Opportunity Complaint Filing (PDF)
Online Directory Change Form (XLS)
Outside Consulting Authorization Form (PDF)
Position Modification Form (PDF)
Request for Reasonable Accommodation (ADA) (PDF)
Name Change Forms
Professional Name Change Request (PDF)
Associated documents (M4: Massachusetts Withholding Form; W4: Federal Withholding Form; and Direct Deposit Form) can be found on the controller's website.
Payroll Forms
These forms can be found on the controller's website.
Retirement Forms
2013 Salary Reduction Agreement (SRA) (PDF)
Tuition Benefit Forms
Center for Early Childhood Education (PDF)
College Age Dependent Tuition Benefits (PDF)
Employees' Tuition Reimbursement (PDF)
Employees' or Spouse/Partner at Smith (PDF)
Tuition Exchange (PDF)
