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Benefits (BEN)

BEN-A001Release of Private Health Information to CMCSS Attorney01/14/2019
BEN-A002Retiree Payment of Monthly Premiums03/17/2023
BEN-A003Retiree ACH Withdrawal of Monthly Premiums03/17/2023
BEN-F001Authorization Agreement for ACH Debits 06/17/2015
BEN-F005Request to Cancel Ins. Blue Cross Blue Shield 12/08/2017
BEN-F006Request to Delete Dependents Med & Dent. Pol. 12/08/2017
BEN-F009403(b) Termination Request 09/13/2018
BEN-F011Retirement 10/17/2023
BEN-F012Change in 403(B) Contribution 09/13/2018
BEN-F029Flexible Benefits Plan Section 125 Election From 02/07/2020
BEN-F032Retirement Insurance Benefit11/04/2024
BEN-F033CMCSS Retiree Life Insurance Policy 01/05/2023
BEN-F036Request to Cancel Flexible Spending Account 04/21/2015
BEN-F042Supplemental Voluntary Life Insurance Cancellation Request 10/21/2021
BEN-F044Payroll Deduction Authorization re On-Site Healthcare 12/08/2023
BEN-F049Retirement Information Checklist 05/15/2024
BEN-F050Sick Leave Bank Enrollment Form 11/13/2023
BEN-F052Sick Leave Bank Request For Days 10/23/2019
BEN-F053Sick Leave Bank Medical Certification Form 10/23/2019
BEN-F062Benefits Letter - Retirement10/28/2022
BEN-F068Benefit Letter - Retirement10/31/2022
BEN-F069Benefits Letter - Termination10/31/2022
BEN-F069aBenefit Letter - Termination08/10/2023
BEN-F071Notice to Retirees - Monthly Premium Payments10/26/2021
BEN-F073Request to Cancel Colonial Supplemental11/03/2016
BEN-F074AFFIDAVIT OF ELIGIBLE DEPENDENT CHILD STATUS05/23/2023
BEN-F075Medicare Eligibility Acknowledgement10/30/2018
BEN-G001Notice of Privacy Practices 09/15/2023
BEN-P001Benefits Enrollment 04/29/2022
BEN-P002Benefits Termination 03/20/2023
BEN-P003Privacy Notice 06/27/2019
BEN-P004Employee Retirement 06/14/2022
BEN-P005Retiree Benefit Changes 08/16/2018
BEN-P008CMCE Insurance Trust Meeting 09/25/2024
BEN-P016Recording Deposit Transmittals for Checks From Employees, Retirees and Insurance Cos. 09/25/2024
BEN-P017Insurance Statement Reconciliation and Payment 11/04/2024
BEN-P018403(b) Enrollment and Payment 11/03/2020
BEN-P021Payments to Beneflex for MedFSA & DCAP Administrative Fees 10/23/2023
BEN-P022Payments for MedFSA/DCAP Account Claims 09/25/2024
BEN-P023Adverse Blue Cross Blue Shield Benefit Appeal Procedure 02/15/2023
BEN-P024Terminating Benefits of CMCSS Employees 04/17/2023
BEN-P025Retiree Payment of Monthly Premiums Procedure 04/12/2023
BEN-P026Sick Leave Bank Enrollment Procedure 09/06/2024
BEN-P027Request For Days From the Sick Leave Bank Procedure 09/15/2023
BEN-P028Probationary Credit for TCRS06/06/2018
BEN-W001Documenting a Cash/Check/or Money Order Payment from a Retiree 02/05/2024
BEN-W003Name Change for Blue Cross Blue Shield of TN 12/09/2021
BEN-W004Completing Retirement Paperwork 05/24/2022
BEN-W005BCBS Work Instruction11/03/2023
BEN-W007Colonial Life Work Instruction11/03/2023
BEN-W008LegalShield Work Instructions11/04/2024
BEN-W009Hartford Voluntary Life Work Instructions11/03/2023
BEN-W010Pinnacle Work Instructions11/03/2023

Certified Staff (CER)

CER-F007Salary Advancement Request 07/02/2013
CER-F007aSalary Advancement Request - Administrator to Certified05/06/2021
CER-F014Worksheet for Teaching and Military Experience09/17/2020
CER-F016Acceptance of Sick Leave 03/03/2017
CER-F016AWithdraw of Sick Leave 03/03/2017
CER-F019ELL Applicant Language Screening Form 06/26/2014
CER-F025Salary Change Based on Education Level for Certified Teachers12/12/2019
CER-F025ASalary Change Based on Education Level for Administrators05/24/2021
CER-F026Temporary Teacher Position Form08/21/2015
CER-F029Certified Administrative Transfer Request08/23/2024
CER-F030Contract for Administrator Hard-to-Fill Supplement09/30/2019
CER-F031Resident/Certified Administrative Transfer Request05/06/2020
CER-F033Teacher on Permit Acknowledgement08/23/2024
CER-F034Reimbursement Contract for Job-Embedded09/24/2024
CER-G001ELL English Fluency Rubric 01/08/2019
CER-P001Certified Staff Application 03/15/2024
CER-P002Student Discount Request Procedure10/17/2023
CER-P004Hiring ELL Teachers Working with English Learners 02/01/2019
CER-P005School Year Preparation Days 01/10/2022
CER-P007Salary Change Request Based on Education Level for Certified Teachers and Administrators12/14/2015
CER-P008Career Ladder Program08/06/2013
CER-P009Salary Change Request Based on Education Level for Administrators01/06/2016
CER-W003Onboarding New Teachers 10/31/2022

Classified Staff (CLS)

CLS-F004Classified Employment Reference Request07/18/2024
CLS-F017Summer Salary Distribution Option 02/16/2021
CLS-F019Verification of Prior Job Experience 03/21/2022
CLS-F019AClassified New Hire Prior Experience/Education Request 03/21/2022
CLS-F019bClassified Transfer Prior Experience Education Request03/21/2022
CLS-F027To Process Substitute Bus Aides 07/18/2024
CLS-F028To Process Substitute Bus Drivers 07/18/2024
CLS-F034School Nurse Performance Evaluation and Clinic Audit Form 10/26/2015
CLS-F038Request for Sub Status03/10/2023
CLS-F039Employee Uniform Receipt12/03/2021
CLS-F050To Process PRN Staff at the On-Site Employee Health and Wellness09/15/2022
CLS-F056To Process Contract/Temp Staff09/15/2022
CLS-F057Temporary Classified Position Form10/01/2021
CLS-F058Classified Employee Review Period Paid Time Off Request07/06/2022
CLS-F059Withdrawal of Sick Leave for Classified Staff09/26/2017
CLS-F061Teacher Pipeline Classified Position Reassignment04/18/2023
CLS-F062Classified Administrative Transfer Request06/23/2023
CLS-F063Classified Employee Sick Leave Acceptance06/23/2023
CLS-F064Bus Driver Evaluation12/07/2021
CLS-F065Bus Aide or Monitor Evaluation06/07/2021
CLS-F066To Process Bus Driver Trainees07/18/2024
CLS-G002Classified Application Process - Frequently Asked Questions11/13/2023
CLS-P001Classified Staff Application 11/13/2023
CLS-P003ParaProfessional Testing 06/23/2023
CLS-P005Technology Summer Help Hiring Procedure04/19/2024
CLS-W001Resignation/Retirement of Classified Employee Work Instruction 03/14/2024
CLS-W002Job Class Code for Classified Staff Work Instruction 03/15/2024
CLS-W003Recommendation for Employment for Transfer of Classified Staff 06/23/2023
CLS-W004Recommendation for Employment New Hire of Classified Staff 07/18/2024

Coordinated Student Health (CSH)

CSH-A001Local School Wellness Policy08/07/2017
CSH-A002Student Alcohol, Drug, and Tobacco Use Policy10/28/2019
CSH-F001Health Screening Form05/24/2021
CSH-F003Fitness Center - Employee Wellness Program Activity Application03/31/2015
CSH-F006Coordinated School Health Screening Information08/01/2024
CSH-F006_SPCoordinated School Health Screening Information_SP08/01/2024
CSH-F007CMCSS Wellness Policy Assessment Tool07/26/2017
CSH-F008Vision and Hearing Screening Results03/26/2024
CSH-F009HOSA Student Agreement for Health Screening Participation08/05/2024
CSH-G001Local School Wellness Guide03/25/2024

Health (HEA)

HEA-A001Communicable Diseases08/14/2023
HEA-A002Emergency First Aid Kit12/09/2022
HEA-A005Medication Storage06/24/2021
HEA-A006Medications Disposal07/23/2018
HEA-A007Emergency Medication Administration12/07/2023
HEA-A009Use of Automated External Defibrillators02/21/2011
HEA-A010Admission Requirements04/06/2023
HEA-A010_SPAdmission Requirements - Spanish Version04/06/2023
HEA-A011Medication Administration11/26/2018
HEA-A011_SPMedication Administration - Spanish Verison02/27/2023
HEA-A012Emergency Anti-Seizure Medication Administration06/10/2020
HEA-A013Individualized Healthcare Plan (IHP) Guidelines07/23/2018
HEA-A014Buildings Under Heightened Risk for Infection06/24/2021
HEA-F006Communicable Disease Notification 06/18/2013
HEA-F007Notice to Parents-Head Lice 03/29/2018
HEA-F007_SPNotice to Parents - Head Lice - SP03/29/2018
HEA-F015Immunization and Physical Examination 08/10/2021
HEA-F015_SPImmunization and Physical Examination08/10/2021
HEA-F017Nurses Notes 03/30/2017
HEA-F024Health Services Student Medication Record 01/28/2019
HEA-F036Asthma Individual Health Care Plan10/26/2018
HEA-F036 Packet_SPAsthma Packet - Spanish03/03/2023
HEA-F036_PacketAsthma Individual Health Care Plan Packet03/19/2019
HEA-F036_SPCMCSS Individualized Healthcare Plan - Spanish10/26/2018
HEA-F037Clinic Referral 02/15/2016
HEA-F037aNurse's Report to the Teacher06/18/2013
HEA-F038Life-Threatening Allergy Individual Health Care Plan01/25/2024
HEA-F038aStandardized Allergy Form_English09/18/2020
HEA-F038bStandardized Allergy Form_Spanish09/02/2020
HEA-F038_PacketLife-Threatening Allergy Individual Health Care Plan 01/25/2024
HEA-F038_SPLife-Threatening Allergy Individual Health Plan04/07/2021
HEA-F040Parent/Guardian Notification (Medication, Minor Injury, Clinic Visit and Supplies) 03/29/2018
HEA-F040_SPParent/Guardian Notification (Medication, Minor Injury, Clinic Visit and Supplies) - Spanish Version03/29/2018
HEA-F042Diabetes Individual Healthcare Plan 05/11/2018
HEA-F042_PacketDiabetes Individual Health Care Plan Packet03/19/2019
HEA-F044Diabetes Record 05/11/2018
HEA-F046Mass Hearing and Vision Referrals 08/08/2016
HEA-F047Vision Referral05/17/2024
HEA-F047_SPVision Referral - Spanish Version05/21/2024
HEA-F049Parent/Guardian Input Tracheostomy Management 06/19/2013
HEA-F049_SPParent Input on Tracheostomy Management - Spanish Version06/19/2013
HEA-F050Hearing Referral Form 05/21/2024
HEA-F050_SPHearing Referral - Spanish07/07/2016
HEA-F051Physicians Orders for Tracheostomy Care 06/19/2013
HEA-F052Authorization for Use or Disclosure of Health Information to and from School Districts 06/17/2021
HEA-F062Authorization for Medication to be Taken During School Hours 03/19/2019
HEA-F062_SPMedication Authorization - Spanish03/03/2019
HEA-F063Seizure Record06/19/2013
HEA-F065Consent for Flu Vaccine08/22/2023
HEA-F066Tube Feeding Flow Sheet 01/23/2018
HEA-F070Physicians Order Form for Oxygen Administration 06/19/2013
HEA-F072Physicians Order Form for Machine Suctioning 06/17/2021
HEA-F073Suctioning Schedule 06/17/2021
HEA-F074Physicians Order Form for Catheterization 06/19/2013
HEA-F076Physicians Orders for Colostomy/Ileostomy Care 06/19/2013
HEA-F077Student Instruction Form Changing Colostomy/ Ileostomy Bag 06/17/2021
HEA-F080Medication Incident Report05/12/2022
HEA-F081Medication Count 05/06/2024
HEA-F084Report of Administration of Diastat 02/10/2011
HEA-F085Invalid Emergency Phone Numbers 06/17/2021
HEA-F085_SPInvalid Emergency Phone Numbers03/11/2024
HEA-F086Confidentiality Statement 06/10/2020
HEA-F089Medication Expiration Notice 07/10/2024
HEA-F089_SPMedication Expiration Notice - Spanish Version03/11/2024
HEA-F090AED Incident Report 12/14/2022
HEA-F092Request for Exemptions from Immunizations 10/26/2018
HEA-F093Notification of Parent-Administered Medication Outside of School Hours 05/25/2023
HEA-F093_SPNotification of Parent-Administered Medication Outside of School Hours - Spanish Version05/25/2023
HEA-F094Medication Administration Skills Checklist 07/26/2023
HEA-F094AMedication Administration Skills Checklist – Diabetes and Glucagon07/31/2023
HEA-F094BMedication Administration Skills Checklist – Seizures and Prescribed Emergency Medications04/19/2023
HEA-F095Notice to Parents - Bed Bugs 10/13/2016
HEA-F095_SPNotice to Parents - Bed Bugs - Spanish Version10/13/2016
HEA-F096Bed Bug Inspection Report10/13/2016
HEA-F097Emergency Medication on School Buses 08/22/2024
HEA-F100Medication Refrigeration Temperature Log10/11/2024
HEA-F101ASchool Emergency Go-Kit Supply List12/09/2022
HEA-F101BNurse Emergency "Go Kit" Supply List05/15/2023
HEA-F103Substitute Nurse Folder Checklist05/21/2019
HEA-F104Substitute Nurse Employment Checklist02/23/2023
HEA-F105Substitute Nurse Information Sheet06/28/2021
HEA-F106School Nurse Diabetic Assessment06/17/2021
HEA-F109Competency for School Nurses Acknowledgement Form07/07/2016
HEA-F110Substitute School Nurse Agreement07/28/2022
HEA-F111School Nurse Competency Checklist03/23/2023
HEA-F113Substitute Nurse Probationary Status and Review Period01/25/2024
HEA-F114Blood Pressure Referral07/07/2016
HEA-F115Individual Health Plan09/19/2017
HEA-F115_SPIndividualized Health Plan - Spanish09/19/2017
HEA-F116Adrenal Insufficiency Skills Checklist04/19/2023
HEA-F117Naloxone Administration Record03/16/2018
HEA-F118Health Services Parent Letter08/02/2024
HEA-F118_SPHealth Services Parent Letter - Spanish08/06/2024
HEA-F119Working Parent Letter - Diabetes11/06/2018
HEA-F119_SPWorking Parent Letter - Diabetes - Spanish Version11/06/2018
HEA-F120Seizure Action Plan02/10/2020
HEA-F120_PacketSeizure Individual Health Care Plan Packet06/12/2023
HEA-F120_SPSeizure Action Plan - Spanish02/10/2020
HEA-F121Diabetes Emergency Action Plan02/10/2020
HEA-F125Allergy Notification Letter09/02/2022
HEA-F126CMCSS Physician Orders and Parent Input for Tube Feeding at School10/24/2024
HEA-F126_SPCMCSS Physician Orders and Parent Input for Tube Feeding at School - Spanish Version10/24/2024
HEA-F127School Nurse Self-Evaluation09/15/2023
HEA-F128Emergency Evacuation Plan10/06/2023
HEA-F129School Nurse Competency Checklist08/05/2024
HEA-G001Bed Bug Management 10/13/2016
HEA-G002Bed Bug Information 02/07/2012
HEA-G010School Nurse Monthly Responsibilities08/06/2021
HEA-G011Substitute Nurse Responsibilities02/15/2016
HEA-G012Life-Threatening Allergy Protocol04/09/2021
HEA-G015Guidelines for Referral to Health Clinic07/17/2018
HEA-G016Head Lice Management Guide03/29/2018
HEA-P001Communicable Diseases 08/10/2023
HEA-P002Medication Administration 01/28/2019
HEA-P003Emergency Anti-Seizure Medication Administration Procedure 06/10/2020
HEA-P004AED Response 06/17/2021
HEA-P006Influenza Vaccine Administration Procedure 09/14/2012
HEA-P007Field Trip Medication06/17/2021
HEA-P009Adrenal Insufficiency07/27/2021
HEA-P010Narcan Procedure03/16/2018
HEA-P011First Aid and Emergency Procedures 08/15/2019

Human Resources (HUM)

HUM-A001Employment Classifications05/15/2017
HUM-A003Personnel File10/06/2022
HUM-A004Employee and Non-contracted Employee Background Investigations10/17/2022
HUM-A005Health Examinations02/25/2013
HUM-A006Legal Leave(s) of Absence08/28/2017
HUM-A007Advance Pay12/05/2022
HUM-A008Hiring Administrators and Supervisors01/07/2019
HUM-A011Work Related Injuries/Illnesses03/18/2024
HUM-A012School System Safety05/01/2023
HUM-A013Staff Gifts and Solicitations02/18/2019
HUM-A014Holidays09/02/2022
HUM-A015Teaching Assignment09/17/2018
HUM-A016Family and Medical Leave Act (FMLA)08/07/2023
HUM-A017Leave for Advance Educational Study04/06/2021
HUM-A018Certified Staff Orientation01/07/2019
HUM-A021Leave Due to Inclement Weather and Other Emergencies02/05/2024
HUM-A022Retirement of Employees03/04/2013
HUM-A023Professional Staff Probation and Tenure06/14/2021
HUM-A024Military Service Leave04/06/2021
HUM-A025Resignation of Instructional Personnel04/07/2015
HUM-A026Certification03/04/2019
HUM-A027Professional Staff Contracts and Compensation Plans10/22/2020
HUM-A028Use of Tobacco Products and/or Electronic Cigarettes on School Premises05/31/2016
HUM-A029Sick Leave08/18/2020
HUM-A030Release of School Personnel or Students Due to Death of Employee or Student04/08/2019
HUM-A031Maternity Leave07/31/2023
HUM-A032Vacations08/20/2021
HUM-A033Other Leaves of Absence02/05/2024
HUM-A034School District Communication System Usage11/26/2018
HUM-A036Evaluation of Professional Staff04/03/2014
HUM-A037Personal Leave07/01/2023
HUM-A038Supervision of Students02/08/2010
HUM-A039Nepotism04/12/2021
HUM-A040Extra Duty07/01/2024
HUM-A041Staffing06/08/2020
HUM-A042Personal On Site Visits by Relatives and Friends08/29/2005
HUM-A043Testing, Training and Tuition Reimbursement09/24/2018
HUM-A044Evaluation of Classified Staff07/08/2019
HUM-A046Employee Compensation Plan09/19/2022
HUM-A047Sexual Harassment07/02/2024
HUM-A049Classified Staff At-Will Employment07/18/2011
HUM-A051Employee Grievance07/01/2019
HUM-A052Progressive Discipline03/11/2019
HUM-A053Adverse Blue Cross and Blue Shield Benefit Appeal02/24/2023
HUM-A054Funding of Contracted Staff by Outside Agencies03/04/2013
HUM-A055Registered Sex Offenders03/17/2023
HUM-A057Compensation for "Off the Clock Work"02/21/2011
HUM-A058Transfers10/04/2022
HUM-A059Employee Perquisites07/13/2021
HUM-A060Classified Employee Review Period07/31/2017
HUM-A061Bereavement Leave Policy05/06/2019
HUM-A062School Year Preparation Day Stipend07/01/2023
HUM-A063Employee Dress Code07/01/2022
HUM-A064Salary Changes Based on Education Level for Certified Teachers10/31/2018
HUM-A066Discipline Conference Policy05/28/2015
HUM-A067Annual Employee Training11/26/2018
HUM-A069Conflict of Interest09/15/2022
HUM-A070Classified Employee Compensation for Events and Travel Time Outside of Scheduled Work Hours12/15/2014
HUM-A071Certified Employee Relocation Incentive07/31/2017
HUM-A072Transporting Students with Personal Vehicle12/11/2017
HUM-A073Substitute Request to Transfer to Classified Position09/11/2023
HUM-A074Substitute Inactivation05/10/2021
HUM-A075Substitute Probationary Substitute Status and Review Period01/27/2020
HUM-A076Substitute Employment Policy06/16/2023
HUM-A077Salary Changes Based on Education Level for Administrators11/26/2018
HUM-A078Leave for Vendor Endorsement04/24/2017
HUM-A079Professional Leave to Serve03/18/2019
HUM-A080Reporting Arrests05/09/2016
HUM-A081Workplace Violence05/09/2016
HUM-A082Break Time to Express Breast Milk04/18/2023
HUM-A083Determining Administrator Salaries06/26/2024
HUM-A084Non-Discrimination07/01/2024
HUM-A085Overtime/Compensatory Time10/20/2023
HUM-A086Employee Work Product Material04/23/2018
HUM-A087Extra-Curricular Supplements02/24/2023
HUM-A088Legislative Leave for Elected Officials11/03/2021
HUM-A089Acquired Immune Deficiency Syndrome & Human Immunodeficiency Virus (AIDS & HIV)10/28/2019
HUM-A090Non-FMLA Policy01/23/2023
HUM-A091Dismissal of Non-Tenured Teachers01/23/2023
HUM-A096Parent Teacher Conference Days11/28/2022
HUM-A096_SPParent Teacher Conference Days - Spanish Version11/28/2022
HUM-A097Safety and Security Expectations: Exterior Doors06/20/2023
HUM-F014Development Plan 12/07/2016
HUM-F016Request for Leave of Absence/FMLA Form08/30/2021
HUM-F028Discrimination Complaint Form07/03/2024
HUM-F030Resignation 12/04/2020
HUM-F031Extension for Leave of Absence/FMLA Form07/28/2015
HUM-F033Disposition of Unused Personal Leave 04/30/2024
HUM-F034Fingerprint Form 05/24/2023
HUM-F036Employee Sexual Harassment Report Form07/10/2019
HUM-F038Report of Investigation of Sexual Harassment Complaint by Employee 07/07/2014
HUM-F043aResults of Physical Examination for Pre-School Teachers & Ed. Assistants 08/19/2020
HUM-F047Personal Data Form 12/18/2014
HUM-F053 (fillable)Corrective Plan 12/07/2016
HUM-F054Corrective Plan Update 12/07/2016
HUM-F057Contract for Testing, Training and Tuition Reimbursement 02/21/2018
HUM-F059Reporting "Off the Clock" Work Acknowledgement Form 11/19/2018
HUM-F060Employee Health Certification 01/12/2010
HUM-F061Employee Grievance Form 01/28/2020
HUM-F064Teacher/Principal Evaluation Grievance Form 06/06/2012
HUM-F067ADA Accommodation Medical Certification 07/12/2016
HUM-F073Change of Address Form09/04/2013
HUM-F075Results of Physical Examination09/12/2013
HUM-F079Authorization for Release of Employment Records05/09/2014
HUM-F083Contract for Relocation Incentive06/25/2024
HUM-F086Personal Leave Request Form for Staff Development Day08/12/2021
HUM-F088Extra-Curricular Activities Experience Verification08/30/2023
HUM-F088ARecommendation for Coaching Position09/08/2023
HUM-F088BResignation of Coaching Position09/08/2023
HUM-F089Noncriminal Justice Applicant04/12/2022
HUM-F089ANoncriminal Justice Employee Privacy Rights06/13/2024
HUM-F090Agency/Supervisor Requesting a Background Check07/14/2023
HUM-F091Request for Background Check Student-Observation-Intern09/22/2022
HUM-F092Request for Copy of Personal Background Check11/01/2018
HUM-F094HIPAA/ Medical Information Confidentiality Agreement05/21/2024
HUM-F095Student Discrimination Complaint Form07/03/2024
HUM-F098Student Intern Memo11/10/2017
HUM-F100Notary Journal Sheet02/28/2018
HUM-F101Background Check Binder Receipt03/13/2018
HUM-F102District Wide Stipend for Late Hires Form07/07/2023
HUM-F103Service Animal Request Form06/01/2018
HUM-F105Current Employee Fingerprint Form05/27/2022
HUM-F108Health Care Provider Form10/10/2018
HUM-F109Health Care Provider Form (Family Member)11/01/2018
HUM-F110Legislative Leave Request11/26/2018
HUM-F113Professional Leave to Serve Request03/13/2019
HUM-F114HR Investigation Tips07/16/2019
HUM-F115Request for Medical Leave of Absence (Non-FMLA)01/06/2020
HUM-F116Short-Term Telecommuting Agreement10/06/2022
HUM-F117Telework Log08/29/2022
HUM-F131Summer Telework Log - 12 Month Employees05/21/2024
HUM-F132Employee Out-of-Zone School Request Form07/14/2021
HUM-F133CMCSS Involvement After Retirement06/10/2021
HUM-F134Administrator Administrative Transfer Request08/06/2021
HUM-F135Telework Authorization09/08/2023
HUM-F136Diversity Mentor Contract06/10/2024
HUM-F137Stipend Sheet for Teachers who Substitute During Planning Periods09/01/2022
HUM-F139Administrator Recommendation06/30/2022
HUM-F140District-Level Recommendation11/30/2023
HUM-G002Training Guidelines for Recognizing Sexual Harassment 01/14/2021
HUM-G004Maternity Leave Guide 11/13/2023
HUM-G011MUNIS Self-Service Guide07/27/2022
HUM-G012_CertifiedCertified Sick Leave Bank Guidelines (Exhibit B)09/25/2024
HUM-G012_ClassifiedClassified Sick Leave Bank Guidelines (Exhibit B)10/17/2023
HUM-G013Relocation Incentive Information08/18/2016
HUM-G018School- and District-level Administrator Announcements10/06/2022
HUM-M001Employee Handbook 04/30/2024
HUM-P001Creation of Employee Record 05/24/2023
HUM-P002Classified Hiring 06/04/2024
HUM-P003New Hire Onboarding 03/15/2024
HUM-P004Name Change 06/13/2023
HUM-P005Job Vacancy Posting 05/25/2023
HUM-P006Leave of Absence Request 07/31/2023
HUM-P008Supplements 11/13/2023
HUM-P009Out Processing a Permanent Employee 04/26/2024
HUM-P010Discrimination Complaints07/03/2024
HUM-P013Hiring Administrators and Supervisors 05/06/2021
HUM-P016Background Verification 07/14/2023
HUM-P017Employment Verification By Mail 09/18/2023
HUM-P018Employment Verification By Telephone 06/13/2023
HUM-P019Reporting Allegations of Sexual Harassment 06/13/2024
HUM-P021Certified Voluntary Transfer Procedure 07/12/2023
HUM-P022Employee Grievance Procedure 02/08/2023
HUM-P023Local Evaluation Grievance of Teacher or Principal 07/24/2013
HUM-P024Certified Hiring 03/15/2024
HUM-P031Employee Perquisites07/13/2021
HUM-P032Reporting Arrests10/06/2022
HUM-P033Workplace Violence04/19/2023
HUM-P034Teaching Assignments02/12/2024
HUM-P036Salary Determination for Extra-Curricular Activities01/04/2024
HUM-P037Certified Employee Relocation Incentive Procedure04/02/2019
HUM-P038Student Observations/Teaching07/30/2020
HUM-P039Requesting a Background Check for Specialized Groups09/08/2023
HUM-P040Site-Based Employee Files10/21/2021
HUM-P041Employee Reporting And References As Related To Sexual Misconduct04/16/2021
HUM-P042Employee Requests for Accommodation Procedure05/22/2024
HUM-P043Service Animal Procedure08/08/2019
HUM-P044ADA Compliance Grievance Procedure09/08/2023
HUM-P045Progressive Discipline Procedure07/01/2019
HUM-P046Requesting a Substitute for Professional Leave08/23/2022
HUM-P047Short-Term Telecommuting Procedure04/20/2023
HUM-P049Employee Personnel File Records Request09/08/2023
HUM-P050Emergency Substitute Coverage Procedure11/13/2023
HUM-P051Employee Address Change Procedure09/25/2024
HUM-W001Tennessee New Hire Reporting 03/28/2007
HUM-W002Verification of Employment 11/13/2023
HUM-W004Unemployment Separation Form Work Instruction 03/10/2023
HUM-W006Employee ID Badge Work Instructions06/13/2023
HUM-W008Staff Name Change 06/13/2023
WH-380-EmployeeWH-380-Employee (external link)
WH-380-FamilyWH-380-Family Members (external link)
WH-384-MilitaryWH-384-Military (external link)

On the Job Injury (OJI)

OJI-A001OJI Injury Reporting Policy03/11/2019
OJI-A002Modified Duty03/11/2019
OJI-F002OJI Program Acknowledgement Form 04/19/2023
OJI-F003Employee Injury Statement 12/09/2022
OJI-F007Risk Management/Safety Department Claim Notes 01/17/2017
OJI-F008On the Job Injury - Information for Injured Employees04/08/2022
OJI-F009Injury Prevention Training07/18/2019
OJI-F010Authorization to Treat06/05/2023
OJI-G001Custodial Light Duty Assignments01/17/2017
OJI-G002Food Service Light Duty Assignments12/05/2018
OJI-G003Teacher Light Duty Assignments01/17/2017
OJI-G004OJI Poster03/24/2022
OJI-P001On The Job Injury 04/05/2022
OJI-PRO1OJI Program 10/01/2024

Onsite Medical (OSM)

OSM-A001Provider/Patient Communication04/22/2021
OSM-A002PHI-HIPAA Policy02/01/2018
OSM-F005Unable to Reach Patient with Test Results Letter04/20/2021
OSM-F006Normal Test Result Letter04/20/2021
OSM-F007In-House Lab Results02/24/2022
OSM-F008PRN Employment Letter11/09/2023
OSM-F008aOnsite PRN Provider Agreement05/22/2024
OSM-F008bOnsite PRN Practical Nurse Agreement08/26/2020
OSM-F009Medical Records Release04/20/2021
OSM-F010Tuberculosis Screening Test04/20/2021
OSM-F012Consent for Treatment of Minor Authorization11/04/2024
OSM-F015Fax Cover Sheet01/22/2018
OSM-F016aProvider Training List01/15/2019
OSM-F019Blood Pressure Log11/09/2023
OSM-F020Patient Referral01/26/2018
OSM-F021Patient Registration 06/07/2021
OSM-F022Patient School-Work Excuse11/21/2022
OSM-F024Patient Sign In Sheet05/13/2015
OSM-F027Blood Sugar Log04/17/2015
OSM-F028DOT Medication Questionnaire08/28/2014
OSM-F029Onsite Employee Evaluation08/06/2013
OSM-F030Onsite Food Diary04/20/2021
OSM-F031Referral Appointment Letter04/20/2021
OSM-F035Procedure Consent Form10/17/2017
OSM-F038Consent and Release for Biometric Screening04/17/2015
OSM-F039Biometric Screening Results Letter04/17/2015
OSM-F041Employee Wellness Representative Stipend Timesheet05/24/2024
OSM-F042DOT Packet Coversheet07/26/2017
OSM-F047Advance Care Plan10/08/2014
OSM-F048DOT - Diabetes Regulation Request for Additional Documentation11/14/2014
OSM-F054Onsite Release Form (Interview)04/20/2021
OSM-F059HIPAA Business Associate Agreement09/20/2019
OSM-F060HIPAA/ Medical Information Confidentiality Agreement07/20/2015
OSM-F062Medical Equipment Loan Agreement07/12/2022
OSM-F063Monthly AED and Oxygen Inspection12/20/2016
OSM-F064Key Control Form (Onsite Clinic)04/19/2023
OSM-F067Allergy Injections Agreement09/22/2016
OSM-F069Onsite Back Lab Duties10/18/2019
OSM-F074Onsite Satellite Clinic Daily Duties02/20/2019
OSM-F075Onsite Vaccine Fridge Temperature Log12/04/2023
OSM-F077Onsite Glucometer Control Log11/02/2016
OSM-F078OJI Employee Work Status Form11/18/2022
OSM-F080Onsite Injections Agreement09/05/2018
OSM-F081Onsite Referral Checklist07/12/2017
OSM-F082Biometric Screening Supply List07/26/2017
OSM-F083Biometric Screening Sign Up Sheet07/26/2017
OSM-F089Declination Statement for the Flu Vaccine 17-1809/19/2017
OSM-F090Expired Medication/Supplies11/02/2017
OSM-F091Narcotics Count Sheet01/22/2018
OSM-F092 Allergen Immunotherapy Administration Form01/24/2018
OSM-F095Medication Drop-Off Patient Form03/16/2018
OSM-F096TB Authorization Form02/22/2018
OSM-F099Onsite New Employee Checklist10/26/2018
OSM-F100Lab Flow Sheet08/15/2019
OSM-F101Onsite Daily Nursing Sheet11/04/2019
OSM-F104Agreement for the Use of Onsite Licensed Mental Health Provider08/14/2020
OSM-F105New Lab Form09/03/2020
OSM-F106Onboarding MOA09/03/2020
OSM-F107Nurse Documentation Audit09/03/2020
OSM-F108MOA Daily Snapshot09/03/2020
OSM-F109Nurse Training Day 1 and 209/24/2020
OSM-F110Nurse Training Day 3-509/24/2020
OSM-F112MOA Checklist06/09/2021
OSM-F113Thermometer Sign In/Sign Out Sheet06/25/2021
OSM-F114Provider Self-Evaluation10/26/2021
OSM-F125Inside Lab Order12/10/2021
OSM-F126Employee Emergency Contact Form08/30/2022
OSM-G002Cleaning and Stocking Exam Rooms10/11/2018
OSM-G004Medication Administration of the Pediatric Patient08/01/2013
OSM-G005Medication Storage08/01/2013
OSM-G006Age Specific Phlebotomy Criteria04/17/2015
OSM-G010Standard Precautions Guidelines06/07/2021
OSM-G011Biometric Screening Guidelines11/20/2014
OSM-G013Oxygen Administration and Operating Safety Instructions11/09/2023
OSM-G014Personal Health Information Access Guide07/27/2017
OSM-M001Onsite Services and Records Manual11/06/2017
OSM-NOPPNotice of Privacy Practices08/01/2013
OSM-P002Procedural Guidelines for PHI Access12/04/2018
OSM-P003Procedural Guidelines for Maintenance, Use, or Transferring/Transmitting of PHI12/04/2017
OSM-W001Medication Administration04/20/2021
OSM-W007Proper Blood Collection04/20/2021
OSM-W013Onsite Dress Code and Personal Appearance02/09/2018
OSM-W016Approved Onsite Abbreviations07/01/2021
OSM-W017Onsite Guidance on Identity Verification10/24/2024
OSM-W018How to Use a Peak Flow Meter06/27/2018
OSM-W019Updox Broadcast Messaging Instructions09/03/2020
OSM-W020Outside Lap Results Process07/01/2021
OSM-W021Loaning Equipment Work Instructions08/05/2022

Risk Management (RSK)

RSK-A001Employee Safety Policy02/21/2011
RSK-A002Employee Safety Training01/22/2021
RSK-A003Personal Protective Equipment Policy05/14/2012
RSK-A005Accident Investigation Policy01/22/2021
RSK-A006Modified Duty01/29/2021
RSK-A007Medical Payments Policy07/30/2018
RSK-F003Confined Space Entry Permit 04/15/2011
RSK-F004Electrical Inspection Checklist 04/15/2011
RSK-F006Excavation Checklist 04/15/2011
RSK-F007Recommended Roof Work Safety Checklist 04/15/2011
RSK-F008Hot Work Permit 12/06/2010
RSK-F012Follow-Up to Safety Assessment10/27/2017
RSK-F015Safety Assessment Checklist05/15/2019
RSK-F016Personal Property Damage or Loss Claim Form08/09/2024
RSK-M004Coaches Handbook05/14/2021
RSK-P001Property Loss Claim 01/26/2017
RSK-PRO1Bloodborne Pathogens Exposure Control 07/28/2010
RSK-PRO10Hearing Conservation 05/12/2011
RSK-PRO11Machine Guarding 07/28/2010
RSK-PRO12Compressed Gas Safety 07/28/2010
RSK-PRO13Fall Prevention/Fall Protection 07/28/2010
RSK-PRO14Lockout/Tagout/Verification 07/28/2010
RSK-PRO15Fire Prevention 07/28/2010
RSK-PRO16Heat Stress Protection 07/28/2010
RSK-PRO17Employee Rights and Responsibilities 07/28/2010
RSK-PRO18Supervisor Responsibilities 07/28/2010
RSK-PRO19Health and Safety Complaint 10/27/2021
RSK-PRO2Confined Space 01/31/2017
RSK-PRO20Departmental Safety 07/28/2010
RSK-PRO21Hot Work Safety 09/30/2024
RSK-PRO3Electrical Safety and Related Work Practices 07/28/2010
RSK-PRO4Ladder Safety 04/15/2011
RSK-PRO5Trenching and Excavation 07/28/2010
RSK-PRO6Personal Protective Equipment 07/28/2010
RSK-PRO7Contractor Safety 01/31/2017
RSK-PRO8Hand Safety Tools 07/28/2010
RSK-PRO9Hazard Communication 01/31/2017

Safety (SAF)

SAF-A001Drug and Alcohol Testing07/22/2024
SAF-A002Safe School Choice05/03/2021
SAF-A003Weapon Free Schools03/30/2015
SAF-A004Drug and Alcohol Use by CMCSS Employees07/22/2024
SAF-A005CMCSS Volunteer Policy02/02/2015
SAF-A006School Lunchroom Visitation08/18/2014
SAF-A007Asbestos Management10/21/2013
SAF-A008School Emergency/Crisis After Action Report10/21/2013
SAF-A009School Searches of Student Cell Phones and/or Electronic Devices03/30/2021
SAF-A010Signing In and Out of CMCSS School Buildings04/18/2016
SAF-A011Radon Monitoring09/05/2017
SAF-A012CPR Policy04/02/2018
SAF-A013Review and Release of School Video Surveillance09/16/2019
SAF-A014Threat Assessment Teams01/25/2021
SAF-A015Visitor Policy07/22/2024
SAF-A016Rental Car Reimbursement Request: Vehicle Claims04/15/2024
SAF-A017Use of Utility Vehicles on CMCSS Campuses09/09/2024
SAF-A018Unmanned Aircraft Systems (UAS)09/12/2024
SAF-F001Student Incident Report Form 11/06/2018
SAF-F004Hepatitis B Vaccine Declination Form 07/25/2012
SAF-F005Bomb Threat Checklist 01/18/2016
SAF-F006Bloodborne Pathogen Exposure 04/06/2011
SAF-F007Emergency Areas 05/12/2011
SAF-F008Emergency Shut-Off Locations for Utilities/HVAC 06/06/2012
SAF-F009Field Trip Emergency Management Procedures Checklist 06/16/2009
SAF-F010Field Trip Emergency Numbers 05/12/2011
SAF-F011First Aid/CPR/AED Trained Personnel 05/12/2011
SAF-F012Hazardous Chemical Storage Locations 12/11/2014
SAF-F014Memorandum of Understanding 05/12/2011
SAF-F015After Action Review09/27/2023
SAF-F017School After Hours Contact Information 05/12/2011
SAF-F018School Demographics 05/12/2011
SAF-F019School Emergency Management Team Contact Information 02/12/2021
SAF-F020Special Needs Procedures Summary Sheet 05/12/2011
SAF-F021Hepatitis B Vaccine Consent 05/22/2012
SAF-F023CMCSS Volunteer Interest Form04/09/2018
SAF-F024Lead Custodian Inspection Questionnaire01/06/2017
SAF-F025School Security Audit08/01/2024
SAF-F026School Safety Committee & Tabletop Session Scoring System09/07/2021
SAF-F028CMCSS Volunteer Code of Ethics02/02/2015
SAF-F029CMCSS Volunteer Agreement04/09/2018
SAF-F030Wet Floor Acknowledgement08/29/2019
SAF-F031Parent/Guardian Request to View School Video Surveillance Footage05/14/2024
SAF-F032SO Authorization Form03/20/2023
SAF-F033Inflatable Waiver and Permission Form04/11/2022
SAF-F033_SPInflatable Waiver and Permission Form04/11/2022
SAF-F034MERT Plan03/03/2023
SAF-F035Reunification Sign Out Records09/11/2023
SAF-F036Reunification Card09/11/2023
SAF-G001School Emergency Management Team Information 09/22/2017
SAF-G004CMCSS Student Safety Guide08/14/2020
SAF-G006Safety Drill and Inspection Guide06/22/2018
SAF-G007School Safety Resources and Engagement Guide07/01/2022
SAF-G008CMCSS Reunification Guidelines09/11/2023
SAF-G009Reunification Supply List09/11/2023
SAF-P001Student Accident Reporting 11/06/2018
SAF-P003Environmental & Health Complaints 04/06/2011
SAF-P004Bloodborne Pathogens 04/06/2011
SAF-P005Hepatitis B Administration Procedure 05/23/2012
SAF-P006District Emergency Communications Procedure 07/22/2021
SAF-P007Standard Operating Procedures for Safety Measures 08/30/2022
SAF-P008School Emergency Communication04/22/2013
SAF-P009Use of School or District Volunteers07/26/2018
SAF-P010Radon Testing Procedure08/22/2017
SAF-P011District Visitor Management System Procedure08/31/2022
SAF-P012Review and Release of School Video Surveillance by Parents Procedure09/20/2019
SAF-P012_SPReview and Release of School Video Surveillance by Parents Procedure09/20/2019
SAF-P013Threat Assessment Process12/16/2020
SAF-P014Fire Alarm Activation Procedure07/23/2024
SAF-PRO1CMCSS Respiratory Protection Program05/29/2019

Substitutes (SUB)

SUB-F005Substitute Daily Report06/06/2023
SUB-F006CMCSS Substitute Folder Requirements06/04/2024
SUB-F010Request for Break in Service Extension Form01/24/2024
SUB-F013Long Term Placement Expectations05/24/2024
SUB-F014Substitute Questionnaire05/24/2023
SUB-F015Substitute Performance Feedback06/04/2024
SUB-G001CMCSS Substitute Program - Guidelines for Accepting Assignments & Family Members12/04/2023
SUB-M001Substitute Handbook07/03/2024

External Documents

Certified Staff (CER)

Public Higher Education Fee Discount Form - HE000708/08/2017

Health (HEA)

Concussion Signs and Symptoms Checklist05/01/2010
Management of Food Allergies: School Treatment03/01/2011
2023 Recommended Immunizations for Children from 7 through 18 years old10/17/2023
2023 Recommended Immunizations for Children from 7 through 18 years old (Spanish)10/17/2023
2023 Recommended Immunizations for Children from Birth Through 6 years old10/17/2023
2023 Recommended Immunizations for Children from Birth Through 6 years old (Spanish)10/17/2023
Guidelines for Health Care in a School Setting

Human Resources (HUM)

Separation Notice09/01/2013
Know Your Rights Poster10/25/2022
Employee Rights Under the Fair Labor Standards Act07/15/2024
Employee Rights Under the Family Medical Leave Act07/15/2024
Know Your Rights - Workplace Discrimination07/15/2024
TOSHA Poster11/01/2022
Unemployment Insurance07/15/2024
Wage Regulations Act07/15/2024
Tennessee Human Rights Commission - Discrimination11/01/2022
Uninformed Services Employment and Reemployment Rights Act11/01/2022

Onsite Medical (OSM)

Preparticipation Medical Evaluation Form & Emergency Treatment/Parents Consent Form07/01/2010