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Forms

The contents of this page are intended for the use of current Washington County Employees. All materials are subject to change without notification.

Forms

  • Authorization for Criminal Record Check
  • Bereavement Leave Request Form
  • Change of Address Packet
  • Compliance Confirmation Form-Child Protection
  • Dental Dependent Certification Form
  • Direct Deposit Form
  • Discrimination Complaint Form
  • Flexible Spending Account Form (TASC)
  • FMLA (Family & Medical Leave Act) Employee's Guide to FMLA
  • FMLA (Family & Medical Leave Act) Employee Rights
  • FMLA (Family & Medical Leave Act) Who to Contact
  • ID Badge Form
  • Job Bid Form
  • Life Insurance Beneficiary Change Form
  • Non-Tobacco User Certification Form
  • Opt Out Incentive Enrollment Form
  • Personnel Requisition Form
  • Preferred Method of Contact Form
  • Provisional Application-Child Protection
  • Retirement Change in Member Contribution Rate
  • Retirement Member Designation of Beneficiary
  • Voya Participation Agreement-Contribution Deduction Form
  • Voya Beneficiary Designation Form
  • Voya Unforseeable Emergency Withdrawal Request
  • W-4 Form
  • Workers Comp Injury Claims Packet
  • Workers Compensation Information
  • Workers Comp Flow Chart





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Contact Us

  1. Washington County
    95 W. Beau Street
    Washington, PA 15301

    Phone: 724-228-6700
    Email Us

FAQs

  1. Help! I'm having a Mental Health Crisis! Who Do I call?
  2. Where can I go to get help with substance abuse problems?
  3. Is there a mental health treatment center that can help children or adolescents nearby?
  4. How do I file a request for Open Records?
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Quick Links

  1. Court of Common Pleas of Washington County, Pennsylvania
  2. Washington County Chamber of Commerce
  3. Washington County Fair
  4. Washington County Penn State Cooperative Extension
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