SEIU District 1199 WV/KY/OH – The Healthcare & Social Service Union - The Healthcare & Social Service Union
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Forms

url Mercy Lorain Assignment Despite Objection Form

url Grievance Form 2-Step

url
 
Grievance Form 3-Step (BrightSpring/ResCare)

url
 
Membership Form

url COPE/PAC Card

url
 
Grievance Withdrawal Form

url Assignment Despite Objection (RNs Only)

url Delegate Nomination Form (State Members Only)

url File a Grievance (State Members Only)

url
 
Updated Delegate Nomination Form

url
 
Settlement Agreement Form (State Members Only)

url
 
Executive Board Excused Absence Request Form

url Submit a Membership Card or Update/Renew Online

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Upcoming Events

  1. Toledo Black History Month Event and Celebration

    February 27 @ 3:30 pm - 6:00 pm
  2. West Virginia Purple Power Lobby Day of Action

    March 5 @ 9:00 am - 4:00 pm
  3. SEIU District 1199 Social Justice Committee Meeting

    March 5 @ 11:00 am - 2:00 pm
  4. SEIU District 1199 Executive Board Regional Meetings

    April 26
  5. Workers Memorial Day

    April 28

View All Events

    Columbus Office

    1395 Dublin Road
    Columbus, OH 43215
    P: 877.419.7348
    F: 614.461.1549

    Cleveland Office

    1771 E. 30th Street
    Cleveland, OH 44114
    P: 877.419.7348
    F: 614.461.1549

    West Virginia Office

    1217 Adams Avenue
    Huntington, WV 25704
    P: 877.419.7348
    F: 614.461.1549

    Toledo Office

    435 S. Hawley Street
    Toledo, OH 43609
    P: 877.419.7348
    F: 614.461.1549

SEIU District 1199 WV/KY/OH – The Healthcare & Social Service Union