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        Employee Benefits  Forms                                                                                                                                                                    

        Click link to view and print forms

  • Employee Information Sheet

  • Form W-4 (pdf)

  • G-4 (pdf)

  • I-9 (pdf)

  • District 2 Immunizations (pdf form)

  • Employment Acknowledgment Form

  • Fair Labor Standards Act

  • Flexible Benefits / Health Insurance Options Memo

  • FLSA comp (pdf)

  • Loyalty (pdf) (Must be Notarized sign at Orientation)

  • Technology Usage Policy #174

  • Medical Form (pdf)

  • Outstanding Wages (pdf)

  • Selective Service Verification (If Applicable)

  • Sexual Harassment Policy Form To Sign

  • Sexual Harassment Policy (pdf)

  • Credit Union (pdf form)

  • Standards of Conduct (pdf)

  • Authorization Agreement For Automatic Deposits

  • Statement on Patient Privacy

  • Acknowledgement of Confidential Requirements

  • Acknowledgement of  Workers' Compensation Treatment

  • Acknowledgement of Unclassified Position (pdf)

  • Acknowledgement of Responsibility To Maintain Current License

  • Health & Wellness Policy / Agreement (Optional)

  • Cogent Systems Applicant  Registration Personal Information Form

  • Cogent Systems Identity Verification Procedures