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Other Forms - Human Resources Office
Human Resources Office
University of Wisconsin-Superior
Old Main 201
Belknap and Catlin
P.O. Box 2000
Superior, WI 54880
ph. 715-394-8220
fax. 715-394-8171
Affirmative Action 
- Employee Confidentiality Form - Employee Confidentiality Acknowledgement form for all employees
- Employee Self-Identification
- Student Informal Complaint/Grievance Form
FMLA Forms
- Family Medical Leave Act (FMLA) Employee Request for Leave
- FMLA Certificate of Health Care Provider for Employee's Serious Health Condition
- FMLA Certificate of Health Care Provider for Family Member's Serious Health Condition
- FMLA Certificate of Qualifying Exigency for Military Family Leave
- FMLA Certificate of Serious Injury or Illness of Covered Service Member for Military Leave
Workers Compensation Forms
- Early Return to Work Program - The University of Wisconsin System has established an Early Return To Work (ERTW) program which will be applied to Worker's Compensation and 230.36 ill or injured employees and, whenever feasible and appropriate, for non-work related ill or injured employees.
- Employee's Work Injury and Illness Report - This form must be filled out by the employee when an incident/injury is reported
- Lost Time Fact Sheet
- Medical Information Fact Sheet
- Safety Coordinator Report
- Supervisor's Accident Analysis and Prevention Report - This form must be filled out by Supervisors when an incident/injury is reported
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University of Wisconsin-Superior is an equal opportunity educator and employer