Human Resources Forms
Authorized Driver Request Form
Benefit Forms
- Benefit-related forms can be found on the Benefits page under the appropriate benefit name.
Disability and Reasonable Accommodation Form
Injury/Illness Reporting Forms
- Reporting Injuries
- Occupational Clinic Poster
- Concentra West Inland Empire Locations
- Employees Report of Injury Form
- Supervisors Report of Injury Form
- Worker’s Compensation Packet
Payroll Forms
- Makeup Time Request (PDF)
- Meal Period Waiver Agreement – English
- Meal Period Waiver Agreement – Español
- Meal Period Exception Log – English
- Meal Period Exception Log – Español
- HMC Timekeeping Exception Log – English
- HMC Timekeeping Exception Log – Español
Rideshare Forms
Staff Handbook Acknowledgement Form
Tax Withholding Forms
HR Forms Contacts
Please contact any member of the HR team for questions related to HR forms.
Adele Vuong
Senior Administrator for Business Affairs & Risk Management and Acting Director for Human Resources
909.607.1018
avuong@babyfeedingshop.com
Patrice Siffert, SHRM-SCP
Associate Director for Human Resources
909.607.4154
psiffert@babyfeedingshop.com
Anu Jindal
Payroll Administrator
909.607.2729
ajindal@babyfeedingshop.com
Catharyne Magro
Human Resources Coordinator
909.607.9700
cmagro@babyfeedingshop.com
Nidia Rivera
Recruiter & HR Generalist
909.607.4096
nirivera@babyfeedingshop.com
José Barajas
HR Analyst & Administrator
909.607.6531
jbarajas@babyfeedingshop.com
Haley Phillips
Recruiter & HR Generalist (part-time)
909.607.4096
hphillips@babyfeedingshop.com