Forms


Returns you to HR's home page.


A reference for employees of the Medina County Board of Commissioners


Departments reporting to the Medina County Board of Commissioners.


Links to EAP & Work/Life Program information and services.


Medina County's Employee Wellness Program home page.


A variety of on-line forms for departmental use.


Useful information covering a wide range of topics.


County Commissioners' Home Page

 
These on-line forms are available for your convenience.

Where noted, forms are in Microsoft Word (doc extension) or PDF formats (pdf extension). Which one you pick depends on your computer's software and/or your preference.

 
 
 
 
SAFETY RELATED FORMS
 
SOUTHWEST GENERAL HEALTH CENTER REFERRAL FORM - Post Accident Testing
 

 

     Microsoft Word format

  

     PDF format 
 

EMPLOYMENT
          Employment Application (PDF) 
          SSA-1945 (PDF)

Section 419(c) of Public Law 108-203, the Social Security Protection Act of 2004, requires State and local government employers to disclose the effect of the Windfall Elimination Provision and the Government Pension Offset to employees hired on or after January 1, 2005, in jobs not covered by Social Security. This particular law requires newly hired public employees to sign a statement that they are aware of a possible reduction in their future Social Security benefit entitlement.