UMPNC INDEPENDENT
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Workload / Representative Forms

  • ​​Workload Review Committee Meeting Minutes Template (Word document)
  • Workload Review Committee Agenda Template (Word document)
  • Dispute Facts Collection Sheet (Word document)
  • Option Generation Worksheet (Word document)
  • Option Generation Worksheet (PDF)
  • PSM Forms (PDF)

Other Forms

  • Reimbursement Request Form (Word document)
  • Bio and Consent For Appointment (Word document)

Employee resources

  • ​Michigan Medicine Office of Counseling and Workplace Resilience (formerly Employee Assistance Program)
  • Michigan Medicine FMLA Information
  • Department of Labor FMLA Information
  • Independent Medical Examinations form for Workman's Compensation
  • Managing Someone Else's Money - free resources from the Consumer Financial Protection Bureau
University of Michigan Professional Nurse Council
4343 Concourse Dr., Suite 230, Ann Arbor, MI 48108-8802​
​UMPNCouncil@gmail.com
  • Home
  • Contract
  • Communications
  • Member Business
    • Representatives
    • Bylaws
    • Forms and Other Resources
    • Weingarten Rights
  • Legal Updates
  • Join