You can choose a personal representative(s) to share your health information with by filling out this form.

Complete this form and file it with your school payroll secretary within 10 days.

Educational paraprofessionals should use this form for initial requests for leaves of absence as well as requests for extensions. Requests for extensions must be submitted prior to the date of expiration of the current leave.

As a new member you are automatically enrolled in the Scheduled Benefit Plan. If you wish to enroll in one of the other UFT Welfare Fund dental options use this form. All other members and retirees who wish to transfer from one UFT Welfare Fund...

If an accommodation request is denied or cannot be provided through informal means, the employee may apply for a formal accommodation by submitting the Accommodation Request Form on page 2. Medical documentation to support the request must be...

For HIP subscribers only, use this In-Hospital Private Duty Nursing Claim Form for the UFT Welfare Fund to cover the costs, after a 72-hour deductible, of 80% of the usual and customary costs of in-hospital services provided by a registered nurse...

Save more than $200 each year in taxes by participating in the city’s TransitChek program.

A step-by-step guide for paraprofessionals applying for salary upgrades.

A guide to applying for salary steps and differentials on the DOE's salary application system.

A guide to applying for a salary step on the DOE's salary application system.

Use this form to decline Welfare Fund benefits for your eligible dependents. You must sign this form and have it notarized.

Use this form to decline all Welfare Fund benefits for yourself and eligible dependents. You must sign this form and have it notarized.

Use this form to decline Welfare Fund dental and/or vision benefits for yourself and eligible dependents. You must sign this form and have it notarized.

Form and instructions from the DOE Science Safety Manual.

Print, fill out this form and mail it in to the UFT to enroll in the UFT Supplemental Health Insurance Program (SHIP).

Print and complete the paraprofessional application only if you are not able to use the online enrollment form.

If there is equipment in your school that is unrepairable, not cost-effective to repair, educationally inappropriate, or a safety hazard, complete this form to have the equipment removed.

Injured employees should submit this form within the first seven calendar days of absence due to injury sustained in the performance of official duties.

Administration for Children's Services Division of Child Care/Head Start Child Care Support Services; Provider / Program Enrollment or Update Request

Although the cost of anesthesia for hospitalization, emergency illness or accidental injury should be covered in full by HIP/HMO, the Welfare Fund will pay 80% of reasonable, usual and customary charges when not covered by HIP/HMO.

For HIP subscribers only, includes a section for member and physician to fill out. Please attach original, itemized, paid bill showing date and item purchased.

Especially for Lab Specialists. Use Page 1 to document the presence of mercury in a science room.

Change in employment status includes return to work, discontinuance of work, increase or decrease of regular hours of work and increase or reduction of wages.

Key Dates and Reminders for the School Year

A DOE guide to Measures of Student Learning (MOSL) in the teacher evaluation system.

List of supporting documents required for enrolling dependents in health benefits

This form is used by school nurses and occupational and physical therapists.

Use this form to file a claim if your eyeglasses were damaged in an assault.