Forms and Policies

Download these forms and policies related to your benefits as an employee of New Hanover Regional Medical Center.

Your Responsibilities

Employees can access current policies on PolicyStat under Web Programs on CapsLive.

Employees and dependents who are covered by the NHRMC Medical Plan need to know which services must be done at what locations in order to receive the maximum benefit.You can find that information in this document: 

NHRMC Plan Facilities

Leave of Absence Forms

Leave of Absence Policy
FMLA Application - EMPLOYEE - Use this form if you have worked here more than one year, have worked at least 1250 hours in the past 12 months,  and you need to take time off for your own serious health condition.
FMLA Application - CARE OF FAMILY - Use this form if you have worked here more than one year, have worked at least 1250 hours in the past 12 months, and you need to take time off to care for your spouse, parent or child up to age 18 with a serious health condition, or for Military Family FMLA.
Other Medical Leave Application - Use this form if you do not qualify for FMLA but need to take leave for consecutive days off due to your own serious health condition.
Leave of Absence Application - Use this form if you will miss more than 10 scheduled shifts due to Personal, Educational, or Military Leave (for Service Members).
Leave Return to Work Process

More Great Benefits

Adoption Assistance Application
Adoption Assistance Policy
CLC Childcare Reimbursement Form
College Foundation Enrollment Instructions
Emergency Travel Assistance and Identity Theft Brochure 
Employee Financial Assistance Policy
Online Will Preparation Brochure 
Tuition Assistance Application
Tuition Assistance Policy
WOW (Work on Weekends) Policy

 

Time Off

Paid Days Off (PDO) Policy
Paid Days Off Donation Form

Retirement

Pension Estimate Request Form