Supervisory Forms

Form Name Content Area Purpose
Affidavit of Acknowledgement for Confidentiality / Records Policy Supervisory Form for Employees to Sign
Affidavit of Acknowledgement for Emergency Preparedness & Fire Evacuation Plans Supervisory Form for Employees to Sign
Affidavit of Acknowledgement for Guidance / Discipline Policy Supervisory Form for Employees to Sign
Affidavit of Acknowledgement for Personnel Handbook Supervisory Form for Employees to Sign
Application Screening Instrument Supervisory Form used by interviewers to evaluate applicants
Candidate Evaluation Form Supervisory Form used by interviewers to evaluate applicants
Certification of Dependency Administration Form for NMSU Dependent Children Reduced Tuition Program
Code of Ethics Agreement / Concordancia de Eticas Supervisory Agreement for DACHS Employees
Daily Attendance Record for Staff Members at Centers Administration Form used by employees to keep track of their time
Declaration Form for Employees Supervisory Form filled out annually by employees
Doña Ana County Head Start 4.00.15 Gifts and Gratuities Supervisory NMSU Rules Regarding Accepting Gifts & Gratuities
Employee Handbook Supervisory DACHS Employee Handbook
Employee Information Form Supervisory Form for Employee to Fill Out Upon Hire
Employment History and References Supervisory Form for employee to fill out
First Report of Injury or Illness Administration Workers Compensation Forms
Hiring Checklist Supervisory Checklist of Forms Needed for Employee File
Job Application Supervisory DACHS Application for Employment
Leave Request Part A & B Supervisory Leave Reporting
NMSU Authority to Release Medical Report Administration Workers Compensation Forms
NMSU Business & Finance Time Sheet Administration NMSU Non-Exempt Time Sheet
NMSU Departure Checklist Supervisory Form used by staff leaving employment with DACHS
Non-Medical Memo Administration NMSU Form for Reporting an on the Job Injury that does not Require Medical Attention
Notice of Accident (Two copies needed) Administration Workers Compensation Forms
On-Site Staff Records – Regular Employees Supervisory Form used to verify every form in employees file
On-Site Staff Records – Substitiute/Temp Employees Supervisory Form used to verify every form in employees file
Reading Requirements Supervisory Form for Employees to Sign Regarding Required Reading of DACHS Documents
Safe Environments Monitoring for Supervisors Administration Form used by Supervisors to monitor Safe Environments when they visit a Center; filed with the Health Specialist and cc to the Ed. Specialist/Director if areas of improvement are noted.
Staff Physical Exam Form Supervisory Form for Dr. to fill out at exam
State of NM Request for Driving Record Supervisory Form filled out by new hires
Student Accident Claim Form Administration NMSU Form For Reporting Accidents
Supervisor Accident Investigation Report Administration Workers Compensation Form
Tuberculosis Screening Assessment Supervisory Form filled out by new hires
Work Schedule Form Administration To List Daily Work Hours
Workers’ Compensation Claims Explanation Administration Workers Compensation Forms
Workers’ Compensation Claims Explanation Administration Workers Compensation Forms
Workers Compensation Procedures Administration All Workers Compensation Forms and Instructions found at the NMSU website