Benefits Forms

Crisis Leave Directive & Forms

Employee Separation Forms:

Clearance Form
Separation Summary

Flex Benefits Forms:

Cafeteria Plan
Election/Change Form
Health Care Reimbursement
Dependent Care Reimbursement

Long-Term Disability:

form for LSUHSC-S Employee
form for treating Physician

Tuition Exemption Form

Worker's Compensation Forms:

Employer Report of Injury/Illness   (.doc)   (.pdf)
Incident/Accident Investigation
On-the-Job Injury
( policy &  forms)

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benefits office

LSU Health Shreveport is an Affirmative Action/Equal
Employment Opportunity Employer.
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