Forms

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Forms

Title Short Description Topic Campus Access
Non-Financial Leave Hours Adjustment

For Department personnel liaisons and payroll to submit form to adjust an employee’s leave hours.
Submit to: Payroll

Leave/Time-Off UC Davis and UC Davis Health Download
Notice of Intent to Change Conditions of Employment

Departments use this form to notify HR of changing employment conditions, HR then notifies the Union.
Submit to: ELR Department

Employee and Labor Relations UC Davis and UC Davis Health Download
Permanent Accommodation

This form is used by both campus and health managers and supervisors to document a permanent accommodation.

For questions on the DocuSign form please email [email protected]

Here are helpful FAQ's for DocuSign.

Disability Management Services UC Davis and UC Davis Health Link
Position Closure Proposal

Complete form to initiate an indefinite position closure proposal.
Submit to: ELR Department

Employee and Labor Relations UC Davis Health Download
Position Closure Special Skills Addendum

Because position closure occurs in reverse seniority order, less senior employees inform departments of special skills that may prevent layoff.
Submit to: Compensation/Classification

Employee and Labor Relations UC Davis Health Download
PPSM 70 Employee Complaint Form

Allows PSS and MSP employees to file an official complaint.
Submit to: ELR Department

Employee and Labor Relations UC Davis and UC Davis Health Download
Pre-Action Review Protocol

This protocol is for use in pre-disciplinary action reviews.

Employee and Labor Relations UC Davis and UC Davis Health Download
Probationary Period - Change End Date (Davis Campus)

Managers and Supervisors can complete this form to request to change and employee's probationary period end date.
Submit to: Department assigned Employee Relations Consultant

Employee and Labor Relations UC Davis Download
Probationary Period - Change End Date (Health Campus)

Managers and Supervisors can complete this form to request to change an employee’s probationary period end date.
Submit to: HR Administration

Employee and Labor Relations UC Davis Health Download
PSS Contract Agreement (exempt)

Defines policies and expectations for hiring exempt professionals and support staff on contract.
Submit to: Hiring departments complete during onboarding and submit to local HR office.

Onboarding UC Davis and UC Davis Health Download
PSS Contract Agreement (non-exempt)

Replace this text with a short description of the form (1-2 sentences). This text will appear in the HR Forms table.

Onboarding UC Davis and UC Davis Health Download
Retired Employee Approvals Form

For managers looking to hire, or extend an appointment for a retired employee and outlines the specific reemployment regulations for individuals who receive a retiree benefit.
Submit to: Local HR office at time of rehire

Recruitment UC Davis and UC Davis Health Download
Separation Checklist for Supervisors

A checklist of responsibilities when a supervisor separates.
Submit to: For supervisor use only.

Employee and Labor Relations UC Davis Health Download
Staff Leave Request

Staff may use form to request leave using vacation, sick, comp time, leave without pay, supplemental family medical leave, or personal leave.
Submit to: Department Manager

Leave/Time-Off UC Davis Download
STAR Plan Nomination Form

Managers and Supervisors can complete this form to nominate someone for the Star Recognition program.
Submit to: Executive Director, then to Vice Chancellor

All, Employee and Labor Relations UC Davis Link
Student Compaction

Please use this template when you are submitting more than 1 Student Compaction due to the 2022 California Minimum Wage Increase:   

  1. Download the Compaction Template. 
  2. Log in to AggieService.
  3. Select service request type "Reports-to Changes"
  4. Attach the completed template as an attachment to the case.
Payroll UC Davis and UC Davis Health Download
Supplement to Military Pay

Active duty military personnel can receive supplemental compensation.
Submit to: UC Davis - If leave is managed by a Shared Services team, please send to the appropriate office otherwise, please provide to your supervisor.
UC Davis Health - submit to: [email protected]

Leave/Time-Off UC Davis and UC Davis Health Link
Temporary Accommodation

This form is used by managers and supervisors to document temporary accommodation.

For questions on the form, please email:
Campus: [email protected] | Health: [email protected].

DocuSign FAQ.

Forms:

Disability Management Services UC Davis and UC Davis Health
TES Assignment Request

Departments complete this form to request temporary employment services (TES).
Submit via Smartsheet

Recruitment UC Davis and UC Davis Health Download
UC Davis Workers' Compensation

For the Davis campus: The link leads to Safety Services, where you will find Workers' Compensation forms, information and assistance.

Workers' Compensation UC Davis Link
UC Procurement Services - Source Selection & Price Reasonableness Justification form

This document must be completed by the requesting Department for all federally funded purchases ≥$10,000 (including tax and shipping) & non‐federally funded purchases ≥$100,000 (excluding tax, but including shipping), to substantiate the appropriateness of source selection and price reasonableness.

All UC Davis and UC Davis Health Download
UCPath Access/Cognos Report Request Form

Departments use this online form to request employees be provisioned access to Cognos Reports and/or UCPath security roles. Visit the local UCPath Security webpage for instructions on using the form and a list of Security Liaisons.

All UC Davis and UC Davis Health Link
UCRP Reemployment Notification

To be completed by retirees who receive monthly retirement income and are reemployed in a senior management or staff position.
Submit to: Onboarding coordinator

Recruitment UC Davis and UC Davis Health Download
Union Job Steward Grievance-Related Release Time Request

Union designated employee representative fills out form to request paid release time for grievance-related activities.
Submit to: Employee's Supervisor

Employee and Labor Relations UC Davis and UC Davis Health Download
Verification of Previous Employment

The Work Number® (TWN) is an automated service providing employees with the ability to quickly deliver proof of employment or income.

Payroll UC Davis and UC Davis Health Link
Volunteer Information Record

Departments may use this form to collect volunteer's personal information. It also serves as a checklist to determine volunteer eligibility, and document volunteer onboarding activities. 
Departments should retain this form as Workers' Compensation will request a copy in the event of a volunteer illness/injury.

Recruitment UC Davis and UC Davis Health Download
Waiver of Recruitment

Form used by departments when applying for a waiver of recruitment as outlined in PPSM-20.

Recruitment UC Davis and UC Davis Health Download
Workers' Compensation Claim Form (DWC 1) & Notice of Potential Eligibility

For the Health campus: Visit the UC Davis Health Workers' Compensation website for forms, contact information and more resources. 

Workers' Compensation UC Davis Health Visit website