Benefit Forms

Benefit Forms

Health Insurance Application document link

Health Insurance Information Change document link

Intent to Donate Human Bone Marrow link

On-Line Beneficiary Forms link

Family & Medical Leave

Family & Medical Leave Request document

Family & Medical Leave Certification by Physician document

Family & Medical Leave Certification for Family Member's Serious Health Condition document

Certification for Qualifying Exigency for Military Family Leave document

Serious Injury or Illness of Covered Service Member for Military Leave document

Catastrophic Leave

Classified Staff Application Form link

Classified Staff Donor Form link

Insurances and the Wisconsin Retirement System

Tax Sheltered Annuity 403(b) Program document link

Salary Reduction Agreement link

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University of Wisconsin-River Falls
410 S. 3rd Street, River Falls WI 54022 USA
Campus Information 715-425-3911