Maryland Department of Budget and Management Forms

This Form is used for authorizing the review of released records and information for the State Employees' Leave Bank Program in Maryland.

This document is used for applying for a Flexible Spending Account (FSA) reimbursement for medical expenses in the state of Maryland. It requires a letter from a healthcare provider explaining the medical necessity of the expenses.

This document is used for submitting claims for Flexible Spending Account expenses in the state of Maryland.

This form is used to authorize the release of personal information in the state of Maryland.

This form is used for the State of Maryland Telework Policy (Post-pandemic) Telework Agreement. It outlines the guidelines and agreement for teleworking in the state of Maryland.

This document is for employees in Maryland who want to return their unused leave bank leave. It provides instructions on how to do so.

This Form is used for enrolling in the Direct Pay program for health benefits in Maryland.

This form is used for enrolling in Cobra health benefits in Maryland.

This form is used for appealing decisions or actions related to equal employment opportunity in the state of Maryland.

This Form is used for requesting leave due to Covid-19 in Maryland.

This Form is used for making a supervisory referral in Maryland's EAP program.

This Form is used for requesting leave to receive a Covid-19 vaccine booster.

This Form is used for enrolling in a Cobra health insurance plan in Maryland.

This form is used for requesting a medical or religious exemption from Covid-19 vaccination in Maryland.