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Saturday, September 23, 2017

Human Resources Forms

Please Note: We have moved forms more suitable only to staff/faculty to the wiki. If you don't see a form you are looking for, please check there.

2017-2018 Benefits

  • 2017-2018 Blue Sheild PPO
  • 2017-2018 Blue Shield Access Plus HMO
  • 2017-2018 Blue Shield Trio HMO
  • Beneficiary Designation/Change Card
  • Benefit Enrollment Form and Rates
  • Delta Dental - PPO Plan Summary
  • DeltaCare USA - Plan Summary
  • Enrollment Guide
  • EyeMed - Plan Summary
  • Health Advocate EAP
  • Kaiser - $20 Plan Summary
  • Kaiser - $40 Plan Summary
  • Blue Sheild Pharmacy Form
  • Vol. AD&D Brochure
  • Vol. Life Insurance

American Fidelity

  • American Fidelity - Accident Plan
  • American Fidelity - Brochure
  • American Fidelity - Cancer Plan
  • American Fidelity - Disability Plan

Leave of Absence Forms

  • Certificatation of Health Care Provider
  • Leave of Absence Application
  • Leave of Absence Instructions

Leave of Absence Information

  • Employee Leave of Absence Instructions
  • Family Care - CSEA
  • Family Care - CTA
  • Medical Disability - CSEA
  • Pregnancy - CSEA
  • Pregnancy - CTA

Workers Compensation - Employee

  • Covered Employee Notification
  • Instructions for Injured Worker

Workers Compensation - Providers

  • FOX Occupational
  • LOMA LINDA UNIVERSITY

Workers Compensation - Supervisor

  • DWC-1
  • Employee Statement
  • Medical Authorization
  • Supervisor Instructions
  • Supervisor Statement
  • Witness Statements
  • Chancellor's Office
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  • About the District
    • Mission Statement
    • Institutional Values & Planning Documents
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      • District Strategic Planning
      • Technology Planning
      • 5 Year Construction Plan
      • Long-Range Staffing Plan
      • Program Review
      • Strategic Planning Brochure
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    • BOT - Board to Board Committee
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  • Human Resources/Jobs
    • Annual Security Report
      • SBVC
      • CHC
      • EDCT
    • Equal Employment Opportunity Plan
    • Title IX
    • Newsletters
    • Employment Opportunities
    • Benefit Information
    • Health Care Reform
      • New Health Insurance Marketplace Coverage Notice
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      • Safety Training
      • EEO Training January 2017
      • HR Professional Development Catalog
      • Professional Development Quarterly Calendar
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    • Salary Schedules
    • Bargaining Agreements
    • FAQs-HR
    • Safety & Risk Management
      • Workers' Compensation-Injury Reporting Claim Forms
      • How to Report An Injury Claim - Nurse Advice Hotline Information
      • Air Monitoring & Assessment Information
      • General Information
        • Contact Us
        • Frequently Asked Questions
        • Safety Board Policies
        • Codes of Safe Practices
        • Safety Inspection Reports - SBVC/CHC/District-Sites
        • Safety Resources - Summary Page
        • NEW MSDSonline Safety Data Sheets (SDS)/SBCCD Chemical Inventory Website
        • SBCCD Job Hazard Assessments
      • Safety Programs
        • Illness and Injury Prevention (IIPP) Safety Program
          • San Bernardino Valley College & Crafton Hills College Injury and Illness Prevention Program - Consolidated
          • District Office Injury and Illness Prevention Program
        • Aerial Work Safety Program
          • San Bernardino Valley College & Crafton Hills College Aerial Work Platform Program - Consolidated
        • Asbestos Operations and Maintenance Program
          • Crafton Hills College Asbestos Operations and Maintenance Program
          • San Bernardino Valley College Asbestos Operations and Maintenance Program
        • Bloodborne Pathogens Safety Program
          • SBVC & CHC Bloodborne Pathogens Program - Consolidated
        • Chemical Hygiene Program
          • Crafton Hills College Chemical Hygiene Program
          • San Bernardino Valley College & Crafton Hills College - Chemical Hygiene Program
        • Fall Protection Safety Program
          • San Bernardino Valley College & Crafton Hills College Fall Protection Program - Consolidated
        • Communicable Disease Safety Program
          • Communicable Disease Safety Program
        • Confined Space Entry Safety Program - Non Permit Required
          • Confined Space Entry - Non Permit Required Safety Program
        • Fire Prevention, Life & Safety Progam
          • San Bernardino Valley College & Crafton Hills College Fire Life Safety Program - Consolidated
        • Forklift - Powered Industrial Truck Safety Program
          • San Bernardino Valley College & Crafton Hills College Forklift - Powered Industrial Truck Safety Program - Consolidated
        • Formaldehyde Program
          • Crafton Hills College Formaldehyde Program
          • San Bernardino Valley College Formaldehyde Phenol Glutaraldehyde Program
        • Hazard Communication Safety Program - Employee Right To Know
          • District Office Hazard Communication Program
          • San Bernardino Valley College & Crafton Hills College Hazard Communication Program - Consolidated
        • Hazardous Waste Management Program
          • CHC Hazardous Materials Management Program
          • SBVC Hazardous Materials Management Program
        • Hearing Conservation Safety Program
          • San Bernardino Valley & Crafton Hills College Hearing Conservation Program - Consolidated
        • Heat Illness Safety Program
          • San Bernardino Valley College & Crafton Hills College Heat Illness Prevention Program - Consolidated
        • Lockout/Tagout (LOTO) Safety Program
          • San Bernardino Valley College & Crafton Hills College Lockout/Tagout Program - Consolidated
        • Respiratory Protection Program
          • San Bernardino Valley College & Crafton Hills College - Respiratory Protection Program
          • Crafton Hills Respiratory Protection Program
        • Sewer Management Program - SBVC/CHC - 2016
          • SBVC & CHC Sewer Management Plan 2016
        • Spill Prevention Control and Countermeasure Program
          • CHC Spill Prevention Control and Countermeasure Program
          • SBVC Spill Prevention Control and Countermeasure Program
        • Utility Safety Safety Program
          • San Bernardino Valley College & Crafton Hills College Utility Cart Safety Program - Consolidated
      • Safety Training
        • UL Pure Safety Online Training Database - SBCCD Full-Time Employees
        • Keenan Safe Colleges Online Safety Training Database - SBCCD Part-Time Employees
        • Videos
      • Safety Committees
        • Crafton Hills College Safety Committee
        • San Bernardino Valley College Safety Committee
        • District Sites Safety Committee - District Admin. Offices, ATTC/PDC & TESS
        • District-Wide Safety Committee
      • Forms
        • Hazard Reporting
        • Ergonomic Evaluation Request
      • Resources/Documents/Links
      • Safety Flash Memos
      • Safety Newsletters
      • Emergency Preparedness Program & Information
        • 8th Street - Annex - Emergency Evacuation Assembly Area Map
        • Alternative Text Production Center (ATPC) - Emergency Flip Chart - 2016
        • ATTC Applied Technology Training Center - Emergency Evacuation Assembly Area Map
        • Blackboard Connect - Personal Information Update Reference Card
        • CHC - Emergency Evacuation Assembly Area Map - Revised October 2013
        • CHC - Emergency Flip Chart - Revised 2016
        • CHC 2012 Building Captain List - Revised October 2013
        • District 2013 Offices-Sites Building Monitor List - Revised October 2013
        • District-PDC Administration Offices - Emergency Evacuation Assembly Area Map
        • District Emergency Preparedness Program - August 2014
        • Redlands/Annex - Emergency Flip Chart - 2016
        • SBCCD District Offices - Admin. Offices-ATTC-PDC - Emergency Flip Chart - 2016
        • SBCCD Hazardous Mitigation Plan
        • SBVC - Emergency Evacuation Assembly Area Map - Revised October 2013
        • SBVC - Emergency Flip Chart - Revised 2016
        • SBVC 2013 Building Captain List - Revised October 2013
        • SBVC Campus AED Locations - Updated 12-2013
        • Deleting Subscribers/Unsubscribing
        • Sending an Alert
        • Evacuation With Disabilities
    • Staff Directory
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    • Health and Wellness
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    • Did you Know
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      • Planning Documents
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    • Presentations
    • Research Reports and Briefs
      • 2017-18 Research Reports and Briefs
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    • SBCCD Services Planning and Program Review
      • District Services Planning and Program Review Committee
  • Facilities Planning and Construction
    • Prequalification/UCCAP
    • Construction Bid Opportunities
      • RFQ-RFP 03-1617-06 for KVCR UHF-to-VHF Transition Project
    • Citizens' Bond Oversight Committee
      • Meeting Agendas/Minutes
    • Reports to the Community
    • Construction Projects Underway
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    • Community Report - Doing What Matters in the Inland Empire
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    • Active Shooter Response
    • Daily Crime Log
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    • Safety Resources
    • Sexual Assault
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    • Upcoming Events
    • Victim Assistance
    • Violence Against Women Act (VAWA)
  • District Wiki (login required)
  • District Faculty & Staff Information/Forms

© 2009 - 2017 San Bernardino Community College District
All Rights Reserved

114 South Del Rosa Drive San Bernardino, California 92408
Phone : 909.382.4000 Fax : 909.382.0116

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