Benefit Enrollment/Change Form - Use this form to enroll in or make changes to the following benefits: Health, Dental Life (including beneficiary information), Short Term Disability, Medical or Dependent Care Flexible Spending Accounts

Dependant Care FSA Acknowledgement Form - Provide this form to your DayCare provider to certify your childcare costs

Emergency Travel Assistance Brochure - Print this brochure and take along with you when traveling in the event you need emergency assistance

FMLA Request Form - Use this form to apply for Family Medical Leave

FMLA Physician Certification - Provide this form to your physician to certify your Family Medical Leave

Evidence of Insurability Form - Use this form to complete the statement of health for life insurance requests over the guarantee issue amount

Short Term Disability Claim Packet - Use this form to apply for benefits under the Short Term Disability Policy

Long Term Disability Claim Packet - Use this form to apply for benefits under the Long Term Disability Policy

Medical FSA Reimbursement Request Form - Use this form to send in receipts to Chard-Snyder to apply for reimbursement under the medical flexible spending account.

Eligibility Determination Form for Shared Medical Leave

Medical Leave Bank Donor Form

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Tuition Waiver Form for Employees

Tuition Waiver Form for Employees
Attending Other KY Institutions

Tuition Discount Form for Dependent Children

Tuition Discount Form for Spouses of Employees
Tuition Discount Form for Part-Time Faculty