Forms – Human Resources | City of Omaha

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Benefits

The forms in this section are commonly used to update/select your benefits due to a qualifying event or to submit a compensation adjustment.

Alegent – Creighton EAP

Beneficiary Update Form

Employee Assistance (EAP) Referral Form

FMLA Employee Serious Health Condition

FMLA Family Member Serious Health Condition

Funeral Leave – Management

Funeral Leave – Non-Management

Funeral Leave – OPD Bargaining

2023-2028 Holiday Calendar

Long Travel Form

Parental Leave Request Form

Refund of Pension Contributions – Civilian

Refund of Pension Contributions – Police & Fire

Refund Tax Notice – Civilian

Refund Tax Notice – Police & Fire

Sick Leave Donation

Sick Leave Request

Compensation

The links on this page are to the forms commonly used to submit a compensation adjustment or request a job study.

Cell Phone Allowance Request

Job Study Position Analysis Questionnaire

Request a New Classification

Tuition Reimbursement Application

Tuition Reimbursement Policy

Employment

The links in this section are related to employee requests and performance appraisals.

Performance Appraisal Template

Talent Acquisition for Managers

More coming soon

Sworn Performance Appraisals

Deputy Police Chief

Captain

Lieutenant

Sergeant

Officer

Labor Relations

The links on this page are to the forms commonly used to submit a compensation adjustment or request a job study.

Civilian Counseling Form

Disciplinary Action – Acknowledgment of Receipt

Disciplinary Action – Suspension Dates Memo

Employee Relations for Managers – Infor (Google Drive folder)

Reasonable Accommodations Form

Safety

The forms in this section are for documenting safety-related issues like reporting vehicle damages and accidents. In addition to accident forms, drug and alcohol forms are also available below. For Injury on Duty (IOD), see Benefits, Compensation, or Workers’ Compensation Forms.

Accident/Incident/Near Miss

Incident Report – Notification to City Safety

Always complete the Incident Report first.

Accident Report of Vehicle and/or Automotive Equipment

Minor Motor Vehicle Accident Information Form

Near Miss Reporting

Property Damage/Vandalism/Theft Report

Report of Occurrence (PDF)

Report of Occurrence (web form)

State of Nebraska Department of Roads Accident Form

Street Maintenance Vehicle Accident Investigation & Reporting Procedures

Driver’s License/CDL

Notification Form – Loss of Driving Privileges – Policy 33

Verification of Driver’s License and Authorization for Release Form – Policy 33

Drug/Alcohol

After Hours Instructions

Consent To Take Drug/Alcohol Test

Observed Behavior – Reasonable Suspicion-Cause Record

Risk Assessment/Pre-Trip Forms

Excavator Pre-Trip Form

Forklift Pre-Trip Form

Hazard Risk Assessment Form

Motor Grader Pre-Trip Form

Snow Plow Pre-Trip Form

Track Loader Pre-Trip Form

Wheel Loader Pre-Trip Form

Training

Simulator Training Request Form

Workers' Compensation

Guide to Workers’ Compensation

Form 50 – Choice of Physician

Initial Report of Injury on Duty

Investigation Report of Injury or Illness

Corvel Mileage Form