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Application for Veterans Flag on Drivers License or Identity Card
Use this form to apply to add a veteran’s flag to your existing Connecticut driver license or identity card. Applications must be received no later than 30 days prior to the expiration date of your license.
Caregiver Med Cert (P-33B)
This medical certificate is to be used by employees seeking family leave to care for a spouse, child (under age 18 or 18 or older and incapable of self-care because of mental or physical disability), or parent with a “serious health condition” / “serious illness”.
Connecticut Wartime Service Medal Application
All Connecticut veterans with qualifying wartime military service are eligible to receive the Connecticut Veterans Wartime Service Medal.
Military personnel records can be used for proving military service or as a valuable tool in genealogical research.
DVA Affirmative Action Discrimination Complaint Procedure
All complaints are to be filed with the Department of Veterans’ Affairs Human Resources Administrator, or in the absence of the Human Resources Administrator, with the Department Manager for investigation.
DVA Afirmative Action Policy Statement
Affirmative Action is a program of positive action, undertaken with conviction and effort, designed to overcome the present effect of the past policies, practices, and barriers to equal employment opportunity.
DVA Legal Internship Application
Internships and Externships for course credit (with authorization by student’s college or university).
Find benefits and resources for State Employees from the Office of the State Comptroller
Employee FMLA Request
Employees are entitled to take up to 12 work weeks of unpaid leave in a 12-month period provided they meet eligibility and reason for leave requirements.
Employee Med Cert (P-33A)
This medical certificate is to be used by an employee who is or will be absent for health reasons including the birth of a child.
Employment and Examination Announcements
Data is updated for viewing on the DAS website on Tuesdays and Thursdays. Users may not have access to or may not see the most recent changes to their record due to this schedule. Be advised all information entered by DAS is immediately available for use by HR Professionals recruiting for state jobs.
Food Service Reservation Form
To reserve Food Services during an event at CT Veterans Home.
Intent to Return to Work (FMLA-HR3)
To be completed by the employee before taking leave under federal FMLA and/or state family/medical leave (C.G.S. 5-248a).
Posthumous Connecticut Wartime Service Medal Application
One (1) Posthumous Connecticut Veterans Wartime Service Medal per Connecticut veteran with qualifying wartime military service who died on or after January 1, 2000 is eligible to be issued to a designated family member.
Request for Authorization to Release Medical Records/Health Information
The form authorizes release of information in accordance with the Health Insurance Portability and Accountability Act, 45 CFR Parts 160 and 164, 5 U.S.C. 552a, and 38 U.S.C. 5701 and 7332 that you specify. Your disclosure of the information requested on this form is voluntary.