Employee Portal


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To make life more convenient for our employees, some of the most frequently used forms can be accessed here. We will add forms to this page as they become available.

Downloadable orientation packets for many of our facilities can be found on our Facility Orientation Packets page.

Annual Required CNAs 12-Hour In Service Training Packages with Test Packets

Time Slip (PDF)

Download this PDF by clicking on the link below, and print it out.

Mileage Report

The form below can be either filled out and submitted online, or printed out and completed by hand. (Click the Print button at the bottom of the form to obtain a printable version.)

Next-Day Pay Advance Request Form

Save time and use this form to request a pay advance. The form is mobile-enabled as well and will work on any devices. Please be certain to follow the instructions, guidelines and deadline precisely. It is our pleasure to offer this benefit to you!

Employee Physical Form (PDF)

You can use this form when securing a medical examination for employment. Check to see if a form is required by your physician.

Employee Self-Health Assessment Form

Employee Information Change Form

You can use this form to communicate changes to your personal records. It is your responsibility to keep us informed as to any name, address or contact information change. In addition, if there are changes to the facilities you wish to go to (or not go to) you may use this form as well.

Direct Deposit Request/Change Form

If you wish to sign up for direct deposit of all or part of your pay, use the form below:
Direct Deposit Sign Up or Change Form

Pay Card Program

Need a pay advance? Want to file a claim for mileage? Want to have your paycheck posted to a pay card for instant access? We highly recommend that each Nurse Connection Staffing employee have a pay card which we are pleased to offer through our partnership with Skylight.

The pay card is just like a debit/charge card. It is a MasterCard, fully FDIC insured, secure and accepted in every community. If you follow the instructions, you will never have to pay a fee for a withdrawal from your pay card.  In addition, earn rewards points simply by using your card (check this out: https://www.skylightpaycard.com/account/index.m; then click Payback Rewards).

Please Note: You must have a PayCard in order to receive any pay advance or mileage reimbursement.

To sign-up for a PayCard, use the form below:

Pay Card Instructions and Sign Up

Want to know more? See this short video:

NCS Employee Time Off Report

Please submit for time to be charged against your accrued benefit time.
Time Off Report Form 


State & Federal Withholding Forms & Information

Click below to open for Form W-4 for Federal Taxes. If you wish to change the number of deductions, you must complete, sign this form and return to the office:
2015 Federal W-4 (Withholding) Form

Click below to open NYS IT-2104 for Withholding and information:

Not sure how many deductions to claim? We found this handy deduction calculator that is free and can provide assistance: http://www.adp.com/tools-and-resources/calculators-and-tools/payroll-calculators/w4-assistant.aspx