Below is a list of medical, reimbursement, benefit forms, and many other form(s) and document(s) related to Human Resources.
- Accident Reporting Procedures
 - Address Change Form
 - Name Change Form
 - Conflict of Interest Summary/Training (English)
 - Conflict of Interest Summary/Training (Spanish)
 - Employment Verification Form
 - ADA Request Form
 - ADA Health Care Provider Questionnaire
 - HIPAA Notice of Privacy Practices
 - Title IX Formal Complaint Form
 
Advance / Master Educator
Benefits Information
Collective Bargaining Agreements
- Administrators Contract
 - Administrative Support Staff Agreement
 - Cafe Agreement
 - Custodian Contract
 - Licensed Practical Nurses Agreement
 - Non-Union Employee Benefit
 - Paraprofessionals Agreement
 - School Safety Officer Collective Bargaining Agreement
 - SEIU Agreement
 - Teachers Union Agreement
 
Colonial Life Voluntary Benefits
- Colonial Life - City of Lawrence Combination of Brochures
 - Colonial Life - How to file a claim - Job Aide
 - Colonial Life - Interest Form 2025
 - Colonial Life - Policy Holder Portal
 - Colonial Life - Request for Service Form
 - Colonial Life - Universal Claim Form
 
Depression and Suicide Information
Employee Assistance Program Information
- Aware Flyer
 - Aware Mindfulness Channel
 - cCBT Flyer-Revised
 - Counseling Flyer
 - Deer Oaks - iConnectYou and Website Access Flyer
 - Deer Oaks Brochure
 - Deer Oaks EAP Back-to-School Flyer
 - Deer Oaks EAP Benefits
 - Deer Oaks EAP Mental Health Poster
 - Deer Oaks EAP Poster Family Mental Health
 - Deer Oaks EAP Poster Its Okay
 - Deer Oaks Life Coaching
 - EAP Poster General Info 1
 - EAP Poster General Info 2
 - EAP Poster General Info 3
 - EAP Poster Financial
 - EAP Poster Confidentiality
 - EAP Flyer Confidentiality
 - EAP Brochure
 - iConnectYou Flyer - Lawrence Public Schools
 - Online Will Flyer
 - Take the High Road Flyer
 - Wallet Card
 - Wellbeing Videos
 - Working Caregiver Flyer
 
Family or Medical Leave
- Leave Procedure
 - FMLA Leave Letter Template
 - FMLA Request Form
 - FMLA FORM 380-E
 - FMLA FORM 380-F
 - FMLA WH-381
 - FMLA Employee Rights
 - FMLA Employee Guide
 
Flexible Spending Accounts (FSA’s)
- FSA Cafeteria Advisors Inc Flyer
 - FSA Contact Information
 - FSA Dependent Care 101
 - FSA Dependent Care Claim - New Address
 - FSA Expense List
 - FSA New Hire Change Flyer
 - FSA New Hire Change of Status Form
 - FSA WEX Health Payment Card
 
Health & Dental Forms
- GIC 2024 Rates if Hired Before July 1,2003
 - GIC 2024 Rates if Hired After July 1, 2003
 - Municipal Employees Retirees and Survivors Benefit Guide 2024-2025
 - GIC Required Documents
 - GIC 2024-2025 Municipal Enrollment / Change Form (FORM-1MUN)
 - GIC Dependent Age 19-26 Enrollment / Change Form - Federal Health Care Reform (ACA)
 - GIC 2023 Disabled Dependent Application
 - Altus Dental Benefit Rates School Year 2024-2025
 - Atlus Dental Enrollment Form 2024
 - Altus Dental Benefit Highlights Plus Plan
 - Altus Dental Mobile Access
 - Atlus Dental Web Access
 
Life Insurance Forms
- Basic Enrollment Card and Declination Form
 - Group Benefits Enrollment Form
 - Evidence of Insurability Form For Group Insurance Form
 
LPS Benefit Enrollment Documents Fiscal Year 2026
- 2025-2026 Altus Dental Biweekly Rates
 - 2025-2026 LPS Benefits Overview English
 - 2025-2026 LPS Benefits Overview Spanish
 - 2025-2026 Municipal Employees, Retirees & Survivors Benefits Guide
 - Altus Enrollment Form 2025 Dental Insurance Coverage
 - Altus Enrollment Form 2025 Retiree Dental Insurance Coverage
 - Altus Web Flyer 2025
 - COBRA General Election Notice
 - GIC 2025 RATES AFTER
 - GIC 2025 RATES BEFORE
 - GIC MUNICIPAL ENROLLMENT & CHANGE FORM 1MUN 2025
 - GIC Dependent Ages 19 to 26 Enrollment Change Form 2025
 - GIC Disabled Dependent Application 2025
 - Harvard Access America 2026 - Summary of Benefits and Coverage
 - Harvard Pilgrim Explorer GIC-2026 - Commercial Member Guide
 - Harvard Pilgrim Explorer GIC-2026 - Summary of Benefits and Coverage
 - Harvard Pilgrim Medicare Enhanced GIC-2026 - Med Enhance Member Guide
 - Harvard Pilgrim Quality GIC-2026 - Summary of Benefits and Coverage
 - Harvard Pilgrim GIC-2026 - Access America Member Guide
 - Mass General Brigham - Health Plan Fact Sheet GIC Benefit Coordinator 2025
 - Mass General Brigham - GIC 070125 Schedule of Benefits
 - Mass General Brigham - GIC 070125 Summary of Benefits Coverage
 - Municipal Retiree & Survivor Health Insurance Enrollment Change 2025 ADA (FORM RS)
 - School Year 25-26 Altus Dental Active Benefit Summary
 - School Year 25-26 Altus Dental Retiree Benefit Summary Spanish
 - School Year 25-26 Altus Dental Retiree Plan Rates Final
 - School Year 25-26 Altus Enrollment Form Dental Insurance Coverage
 - Wellpoint Plan Benefits Summary - MedExt SY25-26
 - Wellpoint Plan Benefits Summary - About PLUS SY25-26
 - Wellpoint Plan Benefits Summary - Cmty-Choice SY25-26
 - Wellpoint Plan Benefits Summary - TotalChoice SY25-26
 - Wellpoint Plan Benefits Summary - TotalChoice SY2025
 - Wellpoint Plan Participation Guide
 - Wellpoint SBC About PLUS SY25-26
 - Wellpoint SBC Community Choice SY25-26
 - Wellpoint SBC TotalChoice SY25-26
 - Wellpoint CVS Caremark Advanced Control Specialty Formulary Effective April 2025
 - Wellpoint CVS Caremark Formulary for Non-Specialty Drugs Effective April 2025
 - Wellpoint Massachusetts Hospitals Acute SY25-26
 
US OMNI & TSACG 403(b) & 457(b) Plans
- US OMNI & TSACG Plan Summary
 - US OMNI & TSACG Benefit Guide
 - US OMNI & TSACG Current List of Provider
 - 403(b) Roth Salary Reduction Agreement
 - 403(b) Salary Reduction Agreement
 - 457(b) Salary Reduction Agreement
 - 403(b) Plan Update 2025 MAC Limits
 
Human Resource Policies
- Acceptable Use Policy
 - Domestic Violence Leave Policy
 - Drug Free Workplace Policy
 - Drug Free Workplace Regulation
 - Physical Restraint Policy
 - ACA Title IX Sexual Harassment Policy English
 - ACA Title IX Sexual Harassment Policy Spanish
 - ACA-R Title IX Grievance Procedure English
 - ACA-R Title IX Grievance Procedure Spanish
 - Staying home to prevent the spread of respiratory viruses | Mass.gov
 
Tuition Reimbursement
TO REQUEST PRE-APPROVAL you must submit the following to 
- Completed pre-approval form signed by your principal
 - A separate one-page course description.
 - Once reviewed, you will receive an email verifying pre-approval.
 
UPON COURSE COMPLETION you must submit the following to 
- Proof of payment that shows the course name and cost of the individual course. (Bursar’s office will have this information)
 - Unofficial transcripts that show your name and the school’s name (only transcripts will be accepted)
 
* PRPIL PROGRAM – See form for instructions (Pre-approval Required)
Reimbursement Forms
- Teacher Tuition Reimbursement
 - LPN Tuition Reimbursement
 - Administrative Support (Clerks) Reimbursement
 - Paraprofessional Tuition Reimbursement
 - PRPIL Program Tuition Reimbursement
 
Path to Licensure
					