Benefit Forms

Forms Online provides IASIS Healthcare employees with instant access to the most recent version of frequently used forms. Use Forms Online to eliminate phone calls, delivery time, and photocopy time and expense. Forms Online is your first stop for self service electronic forms. Select the form you need and print a copy—it’s that easy.

General Employment

  • W-4 (Updated Annually)
    Use this form to withhold the correct federal income tax from your pay.
  • SS-5
    Use this form to apply for a new or a replacement Social Security Card.
  • AZ A-4 Form
    Use this form to calculate and elect to withhold a percentage of one’s pay for Arizona state tax.
  • L-4 Form
    State of Louisiana state income tax form.
  • Direct Deposit Form
    Use this form to have your pay deposited directly to your checking or savings account.

Health and Welfare Plan Forms

Meritain Health Forms




Flexible Spending Accounts

Wells Fargo – 401(k) Forms

  • 401(k) Beneficiary Form
    Contact Wells Fargo directly via the website or 800 number or use this form to designate beneficiary(ies) for plan and submit completed form to your Human Resources Department.
  • 401(k) Distribution Form
    Contact Wells Fargo directly at 800-728-3123 to request the most recent Distribution Form.
  • 401(k) Rollover Contribution Form
    Contact Wells Fargo directly at 800-728-3123 to request to roll money from another eligible account to the Wells Fargo account.

Life and Accidental Death and Dismemberment (AD&D)


Voluntary Benefits

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