DASA HR Forms

COVID-19 Related

• Mandatory Medical On-Site Work Reporting – NEW for August 2020

Employment

• Reference Check Guidelines
• Telephone Reference Check Form
• Creating a Positive New Employee Experience
• Department Offboarding Checklist
• Non-Student Temporary Hire and Access Only Request
• Telecommuting Agreement
• NCSU Equipment Form for Home Use

Leave Programs

• Certification of Healthcare provider – employee
• Certification of Healthcare provider – family members
• Paid Administrative Leave Reporting for COVID-19

Shared Leave

• Voluntary Shared Leave Request Form
• Authorization to Donate Shared Leave

Performance Management

• DASA EHRA Performance Evaluation Form – revised for 20-21 cycle
• DASA EHRA Performance Evaluation Form – use for 19-20 cycle ONLY
• SHRA Performance Plan & Appraisal Form

Exit Interviews

• Exit Survey (please contact your DASA HR Partner to schedule an Exit Interview)

Additional Compensation

• SHRA Supplemental Pay
• EHRA Additional Pay

Worker’s Compensation

• Employee Statement
• Use of Leave Options
• First Report of Injury
• North Carolina Industrial Commission (NCIC) Form 19
• Supervisor’s Medical Treatment Authorization Form 

Other Forms

• DASA Employee Action Notification – (Instructions here)
• Faculty and Staff Giving and Payroll Deduction Form