Revised 11/7/14
Sandhills Community College
Official Personnel File Access Request Form
To schedule an appointment to view or request a copy of your official personnel file please complete
each appropriate section of this form and send via email, fax or campus mail to the Human Resources
Department.
_________________________
Date Submitted
__________________________________________ ______________________________________
First Name Last Name
__________________________________________ __________________________________
Email Address Phone
__________________________________________ __________________________________
Department Job Title
I would like to request an appointment to view my Official Personnel file in the presence of the
Human Resources Director, or their designee, at a location, date and time that is mutually
agreeable. The last date I reviewed my file was ________________.
Completed by HR
Request received by: ________________________________ Date:_________________
Appointment Scheduled for:
Date: _______________________ Time:_______________________
File review completed by:___________________________________ Date:_________________
I would like to request a photocopy of
my Official Personnel File
documents in my personnel file listed below:
________________________________________________________________________
(after a copy of your file has been made, HR will contact you when it is available to pick up.)
Completed by HR
File copy completed by: ________________________________ Date: ____________________
Employee Signature of Receipt: ________________________________ Date: ______________
View my Medical File
Completed by HR
Request received by: ________________________________ Date:_________________
Appointment Scheduled for:
Date: _______________________ Time:_______________________
File review completed by:___________________________________ Date:_________________
Obtain a photocopy of my Medical File
Completed by HR
File copy completed by: ________________________________ Date: ____________________
Employee Signature of Receipt: ________________________________ Date: ______________
Employee Signature: ________________________________________ Date: _______________
__________________________________________________________ Date: _______________
Signature of HR Director or designee
click to sign
signature
click to edit
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signature
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signature
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