Forms
Department of Civil Service Forms | Civil Service Commission Forms
Physical and Medical Requirement forms are available here.
Selected health insurance forms are available in NYSHIP Online for — Employees | Retirees
| Department of Civil Service Forms | PDF (Fill-in) |
| 55 b/c Appointment Request Form | S-90.pdf |
| Authorization for Disability Record | T-252.pdf |
| Authorization for Verification of Non-Disabled Veteran Credits Use | T-252a.pdf |
| Candidate Disqualification Request Form | ADM-155.pdf |
| Canvass Letter-Eligible List | S-60.pdf |
| Canvass Letter-Eligible List (Page 2 ONLY) | S-60.page2.pdf |
| Canvass Letter-Reemployment List | S-61.pdf |
| Canvass Letter-Redeployment List | S-62.pdf |
| Canvass Letter-ARTLs | S-63.pdf |
| Confirmation of Declination-Regular Eligible List | S-64.pdf |
| Confirmation of declination-ARTLs | S-65.pdf |
| Confirmation of Declination-Reemployment List | S-66.pdf |
| Disability Record Authorization | S-7.pdf |
| Disposition of Veterans Credits | S-203.pdf |
| Employee Application for Change in Title or Salary | CC-2E.pdf |
| Existing Position Description (CC-3) | CC-3.pdf |
| Evaluations of Foreign Education | S-916.pdf |
| HIPAA Privacy Complaint | ADM-302.pdf |
| Mandatory Health Examination, Agency Request for | EHS-792.pdf |
| Medical Examination, Agency Request for | EHS-707.pdf |
| Medical Information, Authorization for Release and Disclosure of | EHS-742.pdf |
| Medical Information, Authorization for Drug/Alcohol Testing and Release of | EHS-752.pdf |
| Medical Information to a State Agency, Authorization for Release and Disclosure of | EHS-742-4.pdf |
| Occupational Health Examinations, Agency Request for | EHS-699.pdf |
| Preplacement Physical Examination Request | EHS-769.pdf |
| Reinstatement Examination Request | EHS-705.pdf |
| Request for Eligible List Status Change | S-211.pdf |
| Request to Change Individual Status on Interdepartmental Promotion Eligible Lists | S-211.1.pdf |
| Request for Reconstructed Seniority Date Under Section 80.3 or 80a.3 | S-202.pdf |
| Request for Reinstatement | S-46.pdf |
| Respirator certification pursuant to OSHA standards | EHS-701.8.pdf |
| Workers with Disabilities Program Application Packet (55-b program) | Application Packet |
| Veterans with Disabilities Program Application Packet (55-c program) |
| Civil Service Commission Forms | PDF (Fill-in) |
| Section 211 Application, Pension Waiver Pursuant to Section 211 of the New York State Retirement and Social Security Law |
CSC-1.pdf |
| Leave of Absence Extension | CSC-2.pdf |
| Civil Service Commission Appeal Form | CSC-3.pdf |