Human Resources' online forms require either Adobe Acrobat Reader or Formatta software.

Formatta is only available on-campus. To install Formatta, click on Start, Loyola Software, Updates, Formatta Install.

Click here to download Adobe Acrobat Reader.

Benefits Forms

• Benefits Selection Form - Lakeside Campuses (PDF)
• Benefits Selection Form - Stritch School of Medicine (PDF)
• BlueCross Claim Form (PDF)
• Delta Dental Claim Form (PDF)  
• FSA Reimbursement Request Form (PDF)
• LDA Certification Form (PDF)
• VSP Claim Form (PDF)
• BCBS Prescription Drug Information (Website)
• How to order your PrimeMail Presciptions  (PDF)
• PrimeMail New Prescription Fax order form  (PDF)
• WeightWatchers Program Form (PDF)

Bias Incident Report Form

• Bias Incident Report Form

Change of Address Form

• Change of Address Form

Change of Name

• Change of Name Form (PDF)

Confidentiality Agreement Form

• Confidentiality Form (PDF) 

Conflict of Interest Disclosure Form

• Conflict of Interest Policy

Direct Deposit Form

• Direct Deposit Form (PDF)

Disciplinary Report Form

• Disciplinary Report of Conference (PDF)
• Policy on Progressive Discipline   

Family Medical Leave Act (FMLA)

Family & Medical Leaves are now administered by Matrix Absence Management. To intiate a family or medical leave request, or Short-Term Disability, please call Matrix at 1-877-202-0055 or Matrix on-line claims filing at: www.MatrixeServices.com 

•  FMLA Policy

Giving To Loyola Payroll Deduction Forms

• Payroll Deduction Form
• Faculty and Staff Giving to Loyola Brochure (PDF)

Government Forms

• Federal I-9 Employment Eligibility Form (PDF) 
• Federal W-4 Form (PDF)
• Illinois Dept. of Revenue-Electronic Filing
• Illinois W-4 Form (PDF)    
• Statement of Non-Residence in Illinois

International New Hires   

• Office of International Students & Scholars
• Foreign National Information Form

Leave of Absence Forms

• Request for LOA (PDF)
• LOA Policy

New Hire Forms

• New Employee Packet (PDF)
• Personnel Action Form (Formatta)
• Register for Loyola Alert
• International New Hires

Online Employment Applicant System

• Employment Applicant System (Hiring Officials Only)

Pay and Holiday Calendar

• 2011 Pay and Holiday Calendar (PDF)
• 2012 Pay and Holiday Calendar (PDF)

Performance Improvement Form

• Perfomance Improvement Form (PDF)
• Perfomance Improvement Form (Word)

Personnel Action Forms (PAF)

• Personnel Action Form (Formatta)
• Student Termination Form (Formatta)    

Retiree Forms

• Blue Medicare Rx Enrollment Form
• Information Update Form
• Retiree Computing & Confidentiality Agreement Form (PDF)
• Retiree Health Account Reimbursement Claim Form
• Retiree Medical Plan Enrollment Form  
  

Retirement Forms

• LUERP Estimate Request Form
• LUERP Beneficiary Form

 Tuition Benefit Forms and Information

• FAFSA
• Tuition Benefit Policy and Information 

University Housing Program

• Application
• University Assisted Housing Program Information 

Workers' Compensation

• Limitations Form (PDF)
• Report of Injury (Formatta)
• Workers' Compensation Policy and Information