Forms

Klamath County Human Resources (KCHR) Forms


  1. Direct Deposit Form (PDF)
  2. KCHR1 Employment Requisition (PDF)
  3. KCHR2 Employee Leave Request
  4. KCHR6 B Volunteer Application (PDF)
  5. KCHR7 Property Control In-Out Processing Checklist (PDF)
  6. KCHR8 Injury Report (PDF)
  7. KCHR9 Incident Accident Report (PDF)
  8. KCHR10 3-6 Month Performance Evaluation (PDF)
  9. KCHR11 Annual Employee Performance Evaluation (PDF)
  10. KCHR12 Supervisory Performance Evaluation (PDF)
  11. KCHR13 Relocation Payment Agreement (PDF)
  12. KCHR16 Applicant Release Addendum (PDF)
  13. KCHR28 Guest Passenger Agreement (PDF)
  14. KCHR29A Consent Decline of Testing - Exposure (PDF)
  15. KCHR29B Consent Decline of Testing - Exposure Source (PDF)
  16. KCHR30 Refusal to File 801 (PDF)
  1. KCHR31 Public Use AED Event Information (PDF)
  2. KCHR33 Volunteer Vehicle Form (PDF)
  3. KCHR34 Counseling Statement (PDF)
  4. KCHR34 Counseling Statement-Fillable (PDF)
  5. KCHR35A Pension Plan Update Form (PDF)
  6. New 801_2010 Form (PDF)
  7. Department Head Performance Evaluation (PDF)
  8. Department Head Self Evaluation (PDF)
  9. Emergency Cell Phone Notification Contact (PDF)
  10. KCHR39 Cell Phone Allowance Request (PDF)
  11. KCHR38 HSA Additional Contribution Form (PDF)
  12. KCHR32 Guidelines for Use of Personally Owned Vehicles (PDF)
  13. KCHR3 Employee Information Sheet
  14. Public Records Request Form (PDF)
  15. KCHR15 Employment Reference Verification

Public Records Request Online Form

Risk Management Forms

  1. Bloodborne Pathogen Exposure Incident Accident Report (PDF)
  2. Emergency Cell Phone Notification Contact (PDF)
  3. Hepatitis B Immunization Refusal-Consent and Information (PDF)
  4. KCHR36 Record of Hazard Observed Form (PDF)
  5. KCHR8 Injury Report (PDF)
  1. KCHR9 Incident Accident Report (PDF)
  2. New 801_2010 (PDF)
  3. PPE Hazard Assessment Form (PDF)
  4. Employee Report of Unsafe Conditionor Hazard Form 2018