Forms

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Forms

Title Short Description Topic Campus Access
Labor Pool Available Staff

Use this form to collect information about employees who are available for the labor pool.
Submit to: Fax to 916-734-3080, attention Labor Pool

Recruitment UC Davis Health Download
Mandated Reporter Form

All UC employees are mandated reporters of any suspected child abuse. This form requires the employee’s signature and informs them of the responsibilities related.
Submit to: Copies to Department personnel file and HR personnel file

Onboarding UC Davis and UC Davis Health Download
Mandatory Employment Notices/Posters

List of required federal and state employment notices/posters that is maintained by UC Office of the President with links to each notice/poster. 

All UC Davis and UC Davis Health Link
Meal Period Waiver/Missed Meal and Rest Break

The Meal Period Waiver form is used to waive meal periods for employees that are required to have meal and rest periods in accordance with California Labor Code section 512.1.

The Missed Meal and Rest Break form is used to document if an employee is unable to take their meal or rest break due to an operational requirement or constraint.

Employee and Labor Relations UC Davis
Medical Separation Review

Department uses form to begin the Medical Separation process.
Submit to: Disability Management Service

Disability Management Services UC Davis and UC Davis Health Request form from [email protected]
MSP Contract Agreement

Assists Hiring Departments by defining policies and expectations for hiring managers and senior professionals on contract.
Submit to: Local HR office

Recruitment UC Davis and UC Davis Health Download
MSP Physician Contract

MSPPC

Recruitment UC Davis Health Download
MSP Physician Contract Implementation Guide

MSPPC Guide

Recruitment UC Davis Health Download
MSP Position Description

The official outline to support hiring departments in writing a new position description for managers and senior professionals at UC Davis Health.
Submit to: Recruitment

Recruitment UC Davis Health
Near Relative Request for New Hire

UC Policy defines and regulates employment relationships between near relatives. This form allows hiring departments to submit a request for a near relative hire.
Submit to: Local HR office

Recruitment UC Davis and UC Davis Health Download
Near Relative Request for Relationship Change

UC Policy regulates employment relationships between near relatives. This form allows departments to submit a request for change of relationship between employees. 
Submit to: Local HR office

Recruitment UC Davis and UC Davis Health Download
New Employee Checklist (Davis Campus)

UC Davis supervisors to complete during onboarding process.
Submit to: Share completed list with employee and keep in department files.

Onboarding UC Davis Download
New Employee Checklist (Health Campus)

UC Davis Health supervisors to complete during onboarding process.
Submit to: Share completed list with employee and keep in department files.

Onboarding UC Davis Health Download
No Physical Access Verification (Campus only)

This form verifies and confirms that an employee is not required or expected to physically access a University Location or Program for any work, research, or education/training related purpose, and therefore is not a Covered Individual subject to the requirements of the UC Policy on Vaccine Programs for the period of time indicated below.

All UC Davis Download
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
Online Earnings Statement Exception

Complete if you are requesting to receive a paper Direct Deposit Earnings Statement or you are cancelling a previous request for a paper Direct Deposit Statement and now want to view your statement online.
Submit to: Payroll Services Office, or fax to 530-757-8597

Payroll UC Davis and UC Davis Health Download
Payroll Address Change

Allows employees to notify of an address change to receive paychecks and statements.
Submit to: UC Davis Health Payroll

Payroll 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
Personal Data (UPAY 544)

Provide necessary employment information for payroll and personnel matters.
Submit to: UCOP Payroll

Payroll UC Davis and UC Davis Health Download
Personal Data (UPAY 544A for Union Workers)

Union workers provide necessary employment information for payroll and personnel matters.
Submit to: UCOP Payroll

Payroll UC Davis and UC Davis Health Download
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
Property Recovery & Access Termination

Supervisors acknowledge that they have recovered University property and revoked University systems access for separating employees.
Submit to: UC Davis Health HR Records

Records 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
Request for Staff Records Form

Complete to request the personnel records of current staff members.
Submit to: [email protected].

Records 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
Screening Criteria Grid

Use to screen candidates and identify who to advance to interview.
Submit to: Recruiter

Recruitment 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
Stipend Request

This form may be used for any internal department or division approval processes. 
A formal request to Compensation Services must be submitted via Job Builder at universityofcalifornia.marketpayjobs.com

Compensation UC Davis Health Download
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
Telephone Reference Checklist

Use this form to help conduct a pre-hire reference check.
Submit to: Keep completed form with candidate's application packet.

Recruitment UC Davis and UC Davis Health Download