Mississippi State Department of Health
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Employee Documents

Updated January 17, 2024

Time and Leave

OEPR Emergency/Disaster Response Documents

Current Activation

Additional Forms

Contract Workers and Independent Contractors

Contract Workers

Independent Contractors

Links referenced on this page
Comp Time (Form 43)    http://msdh.ms.gov/msdhsite/_static/resources/18529.pdf
Response Time Verification Sheet    http://msdh.ms.gov/msdhsite/_static/resources/18525.xlsx
Leave (eForms Portal)    https://aw05.doh.miss.gov/msdh/Login.aspx
Resources Status Change (ICS 210)    http://msdh.ms.gov/msdhsite/_static/resources/18528.pdf
OEPR Disaster Response Travel Voucher    https://powerforms.docusign.net/65ecb15d-9c23-48f0-a3ec-0f537388d587?env=na3&acct=ca3d40be-4f16-4a6a-892e-a0fe14f1a6ef&accountId=ca3d40be-4f16-4a6a-892e-a0fe14f1a6ef
Assignment List (ICS 204)    http://msdh.ms.gov/msdhsite/_static/resources/18530.pdf
Documentation Submission Information    http://msdh.ms.gov/msdhsite/_static/resources/18531.pdf
Resource Request Message ICS 213 RR    http://msdh.ms.gov/msdhsite/_static/resources/18527.pdf
Personnel Request ICS 213    http://msdh.ms.gov/msdhsite/_static/resources/18526.pdf
ICS 214 Activity Log    https://powerforms.docusign.net/6445f269-a383-45e3-b6a5-ca793f853d90?env=na3&acct=ca3d40be-4f16-4a6a-892e-a0fe14f1a6ef&accountId=ca3d40be-4f16-4a6a-892e-a0fe14f1a6ef
ICS 214 Activity Log    http://msdh.ms.gov/page/resources/19415.doc
Instructions for Activity Log (ICS 214) via Youtube    https://youtu.be/qWIyHIyvbAw
Instructions for Activity Log (ICS 214) via Microsoft Word    http://msdh.ms.gov/page/resources/19431.docx
Contract Request Form for Contract Workers 1144e    http://msdh.ms.gov/msdhsite/_static/resources/8626.pdf
Contract Request Form Instructions    http://msdh.ms.gov/msdhsite/_static/resources/8627.pdf
Authorization to Release Information for Background Checks 159e    http://msdh.ms.gov/msdhsite/_static/resources/8625.pdf
Human Resources Contract Modification Request 1207e    http://msdh.ms.gov/msdhsite/_static/resources/8622.pdf
Contract Worker/Independent Contractor Determination Worksheet 594e    http://msdh.ms.gov/msdhsite/_static/resources/8621.pdf
Contract Request Form or Independent Contractors 1143e    http://msdh.ms.gov/msdhsite/_static/resources/8624.pdf
Contract Request Form for Independent Contractors Instructions 1143e    http://msdh.ms.gov/msdhsite/_static/resources/8623.pdf
Human Resources Contract Modification Request 1207e    http://msdh.ms.gov/msdhsite/_static/resources/8622.pdf
Contract Worker/Independent Contractor Determination Worksheet 594e    http://msdh.ms.gov/msdhsite/_static/resources/8621.pdf
Resources referenced
Comp Time (Form 43)    https://msdh.ms.gov/msdhsite/_static/resources/18529.pdf ok
Resources Status Change (ICS 210)    https://msdh.ms.gov/msdhsite/_static/resources/18528.pdf ok
Assignment List (ICS 204)    https://msdh.ms.gov/msdhsite/_static/resources/18530.pdf ok
Documentation Submission Information    https://msdh.ms.gov/msdhsite/_static/resources/18531.pdf ok
Resource Request Message ICS 213 RR    https://msdh.ms.gov/msdhsite/_static/resources/18527.pdf ok
Personnel Request ICS 213    https://msdh.ms.gov/msdhsite/_static/resources/18526.pdf ok
Contract Request Form for Contract Workers 1144e    https://msdh.ms.gov/msdhsite/_static/resources/8626.pdf ok
Contract Request Form Instructions    https://msdh.ms.gov/msdhsite/_static/resources/8627.pdf ok
Authorization to Release Information for Background Checks 159e    https://msdh.ms.gov/msdhsite/_static/resources/8625.pdf ok
Human Resources Contract Modification Request 1207e    https://msdh.ms.gov/msdhsite/_static/resources/8622.pdf ok
Contract Worker/Independent Contractor Determination Worksheet 594e    https://msdh.ms.gov/msdhsite/_static/resources/8621.pdf ok
Contract Request Form or Independent Contractors 1143e    https://msdh.ms.gov/msdhsite/_static/resources/8624.pdf ok
Contract Request Form for Independent Contractors Instructions 1143e    https://msdh.ms.gov/msdhsite/_static/resources/8623.pdf ok
Human Resources Contract Modification Request 1207e    https://msdh.ms.gov/msdhsite/_static/resources/8622.pdf ok
Contract Worker/Independent Contractor Determination Worksheet 594e    https://msdh.ms.gov/msdhsite/_static/resources/8621.pdf ok

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