ELLIS CLINIC · FERS APPOINTMENT BUILDER
ELLIS CLINIC · FERS / OPM

FERS Appointment Protocol Builder

Complete the information below, review it, and create a filled copy of the Ellis Clinic FERS Appointment Protocol. Payment-card fields are intentionally left blank.

About You

This builder runs in your browser. Do not use a public/shared computer for sensitive information. The completed PDF should be handled like any other document containing personal information.

Federal Employment

FERS deadline: the supplied protocol emphasizes filing within one year of the last day as a Federal employee.

Conditions That Make It Difficult to Work

Put the most disabling condition first. The original protocol provides eight lines.

Records Checklist

Use this checklist before mailing your packet. It does not change the PDF; it helps you prepare the records requested by the protocol.

Required: the supplied protocol says the official Job Position Description must be included to be given a FERS appointment. Mail the Protocol, records, Summary List, and required fee; Ellis Clinic will then contact you to set up an appointment.

Review & Create PDF