Employee Forms

Below are links to PDF or DOC forms that can be filled-in electronically. Once a form is completed, print it out, sign and date it where indicated and send it to Human Resources.

Frequently Used Forms

Insurance Forms

• Retiree Benefits Enrollment Form
• Retiree Benefits Guide
• Aetna Medical Claim Form
• Aetna Dental Claim Form
• Aetna Vision Claim Form
• Aetna EyeMed Out of Network Claim Form
• Aetna RX Home Delivery (mail order prescriptions)

Forms Needed to Apply for Family Medical Leave of Absence (FMLA)

• FMLA Leave Process Summary
• FMLA Leave Request

Catastrophic Leave Forms

• Catastrophic Leave Application
• Catastrophic Leave Qualifications Sheet
• Catastrophic Leave Healthcare Provider Form
• Catastrophic Leave Donation Form

The City of Round Rock provides an Employee Assistance Program for employees and their families as well as access to low cost legal assistance and education assistance.

• Employee Assistance Forms

Supervisor Forms

Below are some commonly used forms for supervisors.

Disciplinary

• Disciplinary Suspension
• Oral Reprimand
• Written Reprimand
• Performance Improvement

New Hire

• Conditional Job Offer
• Reference Check Form by Fax
• Reference Check Form by Phone
• Top Candidate Form
• NEO Checklist
• New Hire Safety Orientation Checklist

Exiting Employees

• Acceptance of Employment Resignation
• Probationary Employee Termination Letter
• Temporary Seasonal Assignment End

Civil Service Forms and Rules

Forms for Civil Service employees in the Fire Department.

• • Official Application for Promotion Examination
  • Application for Driver Record
  • Notice of Promotional Examination for Fire Lieutenant
  • Notice of Promotional Examination for Fire Driver
  • Civil Service Revised Rules
  • Fire Driver Source Materials
  • Fire Lieutenant Source Materials