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Human Resources Forms
Below are the official LDH Division of Human Resources forms to be used by all LDH offices. Please do not alter any forms without first contacting the LDH Division of Human Resources (225-342-6477). Human Resources may return any altered forms with no action taken.
Forms & Instruction
- ADA Flowchart
- ADA Request for Accommodation HR75
- Certification of Supervisory Elements over Contract Personnel
- Civil Service Rule 6.5g HR20 Instructions
- Civil Service Rule 6.5g Request HR20
- Classified WAE Position Description
- Computation of Leave Prior to Retirement
- CPM Agency Review Form
- CPM Evaluation Form
- CPM Mid-Year Review Form
- CPM Not Evaluated Form
- CPM Notes and Discussion Form
- CPM Performance Development Tool
- CPM Planning Form
- CPM Request Form
- Direct Deposit Enrollment Authorization, Main Bank (Primary Account)
- Direct Deposit Enrollment Authorization, Other Bank (Secondary Account)
- Disaster Operations Time Sheet HR48B
- Disaster Operations Time Sheet Instructions HR 48B
- EEO Complaint Form HR76
- Employee Exit Survey/Questionnaire HR65
- Employee Separation Checklist HR64
- FLSA Determination HR36
- FMLA Alert Form HR31
- FMLA Employee Request Form HR28
- FMLA Flowchart HR80
- Grievance Form HR35
- Human Resources Liaison Checklist HR11
- Justification for Temporary Appointments HR3
- LDH Budget Approval
- LDH Conversion Chart of Minutes to Hours HR114
- LDH Explanation of Policy Template
- LDH Prior Pay Period Adjustment HR74
- LDH Secretary Payroll Certification HR103
- LDH Standard Policy Format
- Leave Request Form SF6
- License Verification Form LV1
- Local Governing Entities - Map
- LSAG Request Form
- New Employee Orientation Checklist HR66
- Notice of Resignation or Transfer Form HR117
- Optional Pay Adjustment Additional Duties Questionnaire
- Optional Pay Adjustment Request HR22
- Overtime Request HR23
- Parental Leave Frequently Asked Questions
- Parental Leave Request Form
- Personal Data Form HR9
- Physical Requirements and Conditions
- Physical Requirements and Conditions Acct Auditor Human Resources
- Physical Requirements and Conditions RN
- Physical Requirements and Conditions Sanitarian
- Physical Requirements and Conditions Social Services
- Position Description Form SF-3
- Premium Pay Request HR58
- Prior State Service Questionnaire HR6
- Recognition and Rewards Request HR24
- Reference Checking HR12
- Request for Personnel Action HR1
- Request to Fill a Vacant Position HR2
- Request to Fill Requiring Executive Approval Form
- SF-3a Optional Attachment
- Shift Differential Request Form HR57
- Statement of Agreement and Understanding HR69
- Student Application SF10D
- Succession Planning Profile Template HR104
- Task Assignment Log HR71
- Telework Formal Agreement HR70
- Training Requirements for All LDH Employees
- Training Requirements for All LDH Contract Workers
- Voluntary Demotion Letter HR67
- Work Schedule Form HR13
Contact
For more information on the Policy Issuance System or a specific policy, please contact [email protected].