Evaluations
Academic Employees, Evaluations
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Updated April 2022.
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The Professional Development Plan (PDP) is a flexible document that reflects the strengths of the candidate and her/his professional development goals.
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For use by Lecturers seeking Range Elevation
Benefits
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Attach supporting documentation and submit to ASIFlex
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Request for Non-Emergency Medical Transportation for Work-Related Injuries
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A Cal-Ore Life Flight membership ensures the patient will have no out-of-pocket flight expenses if flown by the Company or another AirMedCare Network participating provider
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Career Development Plans use an online submission process which provides the opportunity to sign, gain signatures and submit electronically.
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Employee’s Report of Injury (DWC-1) – Must be given to employee at the time injury is reported to Supervisor, or as soon as possible after medical treatment is received
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Predesignation of a Personal Physician
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This booklet contains information and a payment application to help you select the payment method that best meets your needs.
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Employee will need to initiate the form and send it to supervisor for review/approval. Supervisor will need to send the completed form to Ariel.Aaron@humboldt.edu. Please make sure the time is also claimed in Absence Management or claimed on the employee's timesheet
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Supervisor’s Report of Injury – MUST BE SUBMITTED TO HUMAN RESOURCES WITHIN 24 HOURS OF KNOWLEDGE OF INJURY
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Employer Paid Life and AD&D Beneficiary Designation and Change Form
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The VSP Video Display Terminal (VDT) Confirmation Form is only provided to CSU employees who meet the necessary job requirements as determined by the CSU campus benefits office. This form must be completed by the employee and provided to a VSP Select Network doctor to receive the supplemental VDT benefit.
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This is an Adobe Sign Form. You will need to log in with your Humboldt username account. Follow the instructions in the landing page.
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The document includes links to all the necessary forms for the Workers' Compensation process.
Academic Employees, Benefits
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Available to eligible faculty unit employees only.
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Available to eligible faculty unit employees only.
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Tenured Faculty Unit employees who are of normal retirement age (consistent with CalPERS rules and pursuant to the California Code of Regulations (CCR) §586.1) are eligible to participate in the program.
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Notary Pages for Approved Sabbatical and DIP Leaves
Equal Opportunity and Compliance
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This confidentiality form is to be used by applicants or employees who are requesting an accommodation based on a disability. Applicants and employees requesting services will be subject to qualification standards as defined by federal and state laws relating to disability.
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This request form should be utilized for COVID related disability accommodations. Employee/applicant shall contact the treating health care provider to complete this form. Employee/ applicant should return the completed form to ADA coordinator at Humboldt-HR.