01 (Williston) Forms

Primary Phone: 802-662-7831
Regional Director: lesha.rasco@sdplus.org
Operations Contact Information: Click Here for ‘Who to Contact When…’

Available Documents & Forms

• Paychex Employee Portal
• Paychex Mobile Site   (Learn how to use the mobile site, Click Here)

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      Payroll:

1. Time and Attendance Change Forms
   1a. Williston Change Form
   1b. Montpelier Change Form
   1c. Printable PDF Here
2. Time Tracker Form
3. How to Print Pay Stubs from PayChex
4. How to Print W2 from PayChex

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      Human Resources:

1. Employee Policy Manual (04.05.24)
   1a. Policy Acknowledgement Page
2. COVID-19 Program and Exposure Control Plan (04.19.21)
   2a. COVID-19 Exposure Training Plan – with ASRs
   2b. COVID-19 Exposure Training Plan – Powerpoint Presentation
   2c. Acknowledgement of Receipt of Exposure Plan
3. Personal Data Change Form
4. Community Letter
5. Call Out Procedure NVT (9/9/24)
6. Incident Report (04.08.22)
7. Support Incident Report Form (01.22.20)
8. NVT Staff and Student Injury Form  (*Preferred Provider List*) (10.22.24)
9. How to Setup Your New PayChex Employee Account
10. Bi Flow Chart
    
11. Employee Performance Summary (04.08.22)
12. Weather Related Closings and Delays
13. Reference and Recommendations Guidelines
14. Reference Check Approval Form
15. Office Hours Protocol (03.30.22)
16. NVT Technology Security and Platform Info (rev 12.30.20)
17. HIPAA Breach Notification Policy
18. Employee Evaluation Form
19. 2024 BI Pay Scale
20. NVT Sick Policy
21. Assessment of Supervisors (360 eval)
22. Supervisors (11.05.24)
23. Abbr. Employee Number List (SdCloud)
24. Employee ID List (11.05.24)
25. 401k Plan Fee Disclosure (10.22.24)

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      Health Insurance & Other HR Notices:

1. Cobra Initial Notice
2. COVID-19 Extension Notice
3. Medicare Part D Notice
4. Newborn’s Act Notice
5. Patient Protections Notice
6. WHCRA Notice
7. FMLA Notice
8. USERRA Notice
9. CHIPRA Notice
10. Special Enrollment Disclosure
11. QMCSO Notice

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      Client Materials:

1. Medication Intake Form
2. S.U.P.P.O.R.T. Training Techniques
3. Calendar for Meds
4. Form 4500 page

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      Calendars:

1. Payroll Calendar 2024
2. Program/Staff Calendar 2024
3. Payroll Calendar 2025
4. Program/Staff Calendar 2025

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      Reimbursement:

1. WeCU Savings Account
   1a. Reimbursement Request Form (NVT)
   1b. NVT Savings Account Approved List
   1c. Tracking Sheet 
2. Materials / Purchase Form (Read me first: Materials Form Quick Reference)

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      Special Requests:

1. Scheduling Change Form
2. Schedule Changes for the Week – Audit
3. Schedule Request Form
4. Hipaa Authorization to Release Health Information Form
   What info qualifies as PHI (Protected Health Information)? Click Here

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