Forms

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The forms below are frequently used by DOA sections and the Office of Human Resources (OHR) to initiate personnel actions for DOA employees. All forms should be printed and forwarded to the OHR in hard copy form.

Americans with Disabilities Act (ADA)

Medical Inquiry Form

Request for Accommodation Form

Attendance

Flexible Hours Request Form

Attendance/Leave, Work Hours Guide

Student Employee Time Sheet (Recommended Format)

Benefits

Lasers Change of Address Authorization

Cellular Phones/Mobile Devices

Justification Memorandum for Wireless Communication Devices

Cellular Phone/Mobile Device Policy Acknowledgment and Certification Form

Classification

Position Description

Certification of Supervisory Elements Over Contract Personnel

Change of LA Gov HCM Org Unit and/or Reporting Relationship Request

Classified WAE Position Description

Statement of Agreement and Understanding - Employment in a Non-Permanent Appointment

Compensation

Release for Reference Checking

Verification of Employment [6.5(g)] Request

On-Call Pay Request Form

Shift Differential

Special Projects/Significant Achievement

Education/Training/Certification Application

Optional Pay Grid

Optional Pay Adjustment Questionnaire

Voluntary Demotion (Reduction in Pay)

Voluntary Demotion (Waiver of Pay Reduction)

Computation of Student Pay - DOA Regular Student Workers

Computation of Student Pay - OTS Technical Student Workers

Crisis Leave

Crisis Leave Donation Form

Crisis Leave Request Form

Detail to Special Duty

Request for SCS Director Approval of Detail to Special Duty

Discrimination and Harassment

Prohibiting Discrimination and Harassment Form

Prohibiting Sexual Harassment Form

Drug Testing

Conditional Offer of Employment

Drug Test Consent and Release for Non-Minor

Drug Test Consent and Release for Minor

Family and Medical Leave

Employee Serious Health Condition

Family Member Serious Health Condition

Serious Injury or Illness of Covered Service Member for Military Family Leave

Qualifying Exigency for Military Family Leave

Family First Coronavirus Response Act

Employee Instructions for Requesting and Using Leave under FFCRA

Employee Request Form for Leave Under FFCRA

FLSA

FLSA Questionnaire

Grievance

Grievance Forms

Hiring

Conditional Offer of Employment

Request to Recruit for a Vacant Position

Section Induction Checklist

Release for Reference Checking

State of Louisiana Employment Application (SF-10)

Application for Student Employment (SF-10D)

Application to Employ Minors Under Age 18

Leave

Special Leave Request

Prior Pay Period Time Adjustment

Documentation Online Time Entry

Validation Online Time Entry Data Reports

Outside Employment

Outside Employment Disclosure Statement

Employee Acknowledgement of Outside Employment Policy (New Hire/New Position)

Overtime

Statement of Agreement or Understanding Regarding Compensation for Overtime Work

Overtime Compensatory Request Form

Performance Evaluation System

PES Planning & Evaluation Form (To be used by sections within the DOA)

PES Planning & Evaluation Form (To be used by Executive Department Agencies Supported by DOA/OHR)

Personal Data

Name, Address & Phone Number Change Form

Personnel Action Request

Personnel Action Request Form

Personnel Action Request Form Instruction

Probationary Period

Probationary Appointment Acknowledgement

Separation

DOA Separation Procedure

Separation Form

Checklist for Exiting Employee

Temporary Help (WESTAFF)

Temporary Help Requisition

Telework

Telework Agreement Form

Unclassified Authority

Request for Exemption from the Classified Service Form

Statement of Agreement and Understanding - Employment in a Non-Permanent Appointment

Unscheduled Absenteeism Notice

Unscheduled Absenteeism Notice