Erlanger Health System
975 East Third St.
Chattanooga, TN 37403
423-778-7000

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Human Resources Department
975 East 3rd St.
Chattanooga, TN 37403
(corner of 3rd & Hampton St.)
423-778-7969

Hours:
Mon, Wed, Fri
8:00 a.m. – 4:00 p.m.
Tue, Thu
7:00 a.m. – 4:00 p.m.
800-490-JOBS (5627)

Benefits - Forms

Allied Dependent Care Reimbursement Form (28 KB PDF Document)

Allied Medical Reimbursement Form (28 KB PDF Document)

BCBS Enrollment Form (48 KB PDF Document)

Beneficiary Form (72 KB PDF Document)

Beneficiary Designation Group Life AD&D (52 KB PDF Document)

Benefits 2007 (80 KB Word Document)

Change of Status Form (16 KB PDF Document)

COBRAEnrollment (32 KB PDF Document)

Flex Account New Enrollment Form (20 KB PDF Document)

Supplemental Life Medical Form (164 KB PDF Document)