Disability Services Forms

Military Related Leaves

Beginning December 16, 2020, leaves of absence will be requested in Workday (workday.wsu.edu). See Workday Knowledge base reference guide Employee Request a Leave of Absence for instruction.

• Military Caregiver Leave Health Care Provider Statement – Covered Veteran
• Military Caregiver Leave Health Care Provider Statement – Active Servicemember
• Military Leave Certification of Qualifying Exigency
• Your Rights Under Uniformed Services Employment and Reemployment Rights Act (USERRA) – DOL Poster

Modified Duties – Faculty

• Faculty Modified Duties Request

Reasonable Accommodation

• Accommodation Request for Disability or Serious Medical Condition
• Medical Release Statement for Reasonable Accommodation Requests
• Health Care Provider Statement for Reasonable Accommodation Requests
• Pregnancy Accommodation Request Form

Shared Leave

Beginning December 16, 2020, shared leave requests and donations will be processed through Workday (workday.wsu.edu). See Workday Knowledge base reference guide Employee Request a Leave of Absence for instruction.

• Shared Leave Health Care Provider Statement – Medical Conditions
• Shared Leave Employee Request-Pregnancy Disability or Parental Leave
• Shared Leave – Employee Request Form – Domestic Violence, Sexual Assault, Stalking

State of Washington Shared Leave Pools

• Shared Leave Employee Request – Uniformed Services Shared Leave Pool – State of Washington
• Shared Leave Donor Form – Uniformed Services Shared Leave Pool – State of Washington
• Shared Leave Employee Request – Veterans’ In-State Service Shared Leave Pool – State of Washington
• Shared Leave Donor Form – Veterans’ In-State Service Shared Leave Pool – State of Washington
• Shared Leave Employee Request – Foster Parent Shared Leave Pool – State of Washington
• Shared Leave Donor Form – Foster Parent Shared Leave Pool – State of Washington

Victims of Domestic Violence, Sexual Assault or Stalking Leave

• Domestic Violence Leave Request

Washington Paid Family & Medical Leave

• Online Application
• Paid Family & Medical Leave – Statement of Employee Rights – ESD
• Paid Family & Medical Leave Poster – ESD

Workers’ Compensation

• Online Incident Report
• Supervisors Accident Investigation Report
• Activity Prescription Form
• Minor Volunteer Consent and Release
• Volunteer Monthly Report
• Witness/Injured Person Statement
• Workers’ Compensation – File a Claim
• Notice to Employees – If a Job Injury Occurs – L&I Poster
• Your Rights as a Worker in Washington State – L&I Poster