Complying with Employment Record Requirements - SHRM 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your full name in the 'EMPLOYEE NAME' field, followed by your division in the designated area.
3. Fill in your primary and alternate phone numbers to ensure you can be reached during an emergency.
4. Provide your home address, including street, city, state, and zip code, ensuring all details are accurate.
5. Identify your primary emergency contact by entering their name, relationship to you, and their home address along with their phone numbers.
6. If applicable, fill out the secondary emergency contact information using the same format as above.
7. Complete the health care provider contact information if you have pre-designated a physician.
8. Review the employee statement carefully before signing and dating the form to confirm accuracy and understanding of confidentiality.
9. Finally, follow routing instructions to deliver the completed form to your Division Personnel Liaison for processing.

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