Employers use Form SH-3 to document any safety incidents or accidents that occurred and the action taken as the result of an accident.
Preview / Forms
The Personnel Advisor library contains over 100 human resource forms, checklists, and policies. Our interactive forms are designed to assist employers and HR professionals in the productive and prudent use of human resources. They save time by reducing the administrative workload and help employers avoid personnel problems and legal compliance issues.
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Note: Mandatory written notices that must be distributed to employees are located in the Posters section under "Mandatory written notices."
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ACCIDENT INVESTIGATION REPORT
AFFIRMATIVE ACTION PLAN MODEL
Form EO-2 can be used to document Affirmative Action analysis.
APPLICATION FOR EMPLOYMENT
Application for Employment (Form S-4) may be used to obtain information from prospective job applicants.
ATTENDANCE LOG
Use the Attendance Log Form to track employee attendance for an entire year. Record vacation, sick days, family leave and other absences.
CHECKLIST FOR BARRIERS FOR DISABLED WORKERS
Use Form EO-1 to assess workplace compliance with accessibility design standards to accommodate persons with disabilities.
CHECKLIST FOR NEW EMPLOYEES
Form S-7 (Orientation of new employees) is a check list of topics that should be covered with the new employee during his/her first week of employment.
CHILDREN'S HEALTH INSURANCE PROGRAM NOTICE
Employers that live in states that offer premium assistance under state Medicaid or the Children’s Health Insurance Program (CHIP) must provide a model notice to inform employees of potential opportunities available for premium assistance. The notice is required under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), and must be provided annually to employees on the first day of each plan year.
CHIPRA Notice: English (expires 1-31-2023)
CHIPRA Notice: Spanish (expires 1-31-2023)
COBRA MODEL FORM (PA MINI-COBRA))
Pennsylvania Mini-COBRA General Notice: the employer is required to send out the notice to eligible employees within 30 days after a qualifying event.
COBRA MODEL FORMS (FEDERAL COBRA)
The sample COBRA forms are based on model forms provided by the U.S. Department of Labor. Certain provisions might not be appropriate for a given company's health plan. Employers should take care to conform it to the particulars of their plan (s).
Model COBRA General Notice: English (expires 1-31-2023)
Model COBRA General Notice: Spanish (expires 1-31-2023)
Model COBRA Election Notice: English (expires 1-31-2023)
Model COBRA Election Notice: Spanish (expires 1-31-2023)
