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Forms to Bring to Check-In Day
Forms To Bring To Your Check-In Day
Students are required to study the training materials posted on this web-page (see the links provided below) prior to your attendance. You must then print, complete, and bring with you all forms which will be collected at the orientation. Allow yourself four weeks before Orientation Day to gather all the mandatory paperwork and immunizations. You will receive 4 hours of service credit for completing all paperwork.
On Check-in day, you MUST submit your forms during Check-In Time (from 2:00 PM to 4:00 PM). We collect your paperwork before you may attend orientation. Any missing items from the list below will disqualify you as a volunteer applicant, and you will be instructed to re-apply at a later date. There are no exceptions to this policy. No copies will be made of your paperwork including immunizations. All items submitted and found to be incomplete will later be discarded; therefore, you should make copies for your own records.
You will need Adobe Acrobat to open the following PDFs 
. For a free copy of this program, please visit Adobe Acrobat website.
ATTENTION: HIGH SCHOOL STUDENTS: IF YOU DO NOT HAVE A VALID DRIVER'S LICENSE OR PASSPORT, YOU WILL BE REQUIRED TO HAVE A GOVERMENT ISSUED ID, I.E., CALIFORNIA ID CARD TO OBTAIN YOUR BACKGROUND CHECK (DONE AFTER ORIENTATION). NO SCHOOL IDS ARE ACCEPTED. PLEASE APPLY FOR YOUR ID CARD AS SOON AS POSSIBLE IF YOU DO NOT HAVE A VALID DRIVER'S LICENSE OR PASSPORT.
Training Materials to Study:
- Orientation Guide
- Volunteers' Assignment List
- Dress Code
- Confidentiality Agreement and Abuse Reporting
Forms to Print, Complete and Bring with You on Check-In Day:
- Patient Care Coversheet (for Patient Escort or Chase Child Life Program volunteers only)
- Non-Patient Care Coversheet (All volunteers except for Patient Escort or Chase Child Life Program volunteer)
- Volunteer Agreement
- Abuse Reporting (Signature Forms)
- Orientation Guide Quiz
- High School Student Volunteers' Medical Clearance (for students who are under 18 years old)
- Job Description
- TdapDeclination
- IMPORTANT:You will need to generate a temporary I.D. to complete the following On-line training modules.
- HIPAA Privacy and Information Security Training
- CICARE Annual On-Line Training
- Safe Patient Handling Training
Proof of Immunization Forms
Applicants MUST bring a copy ( will not be returned)of their immunization records to orientation (see page 8 in the Orientation Guide listed above). UCLA has very specific requirements for immunizations in order to volunteer. Please note, UCLA requires TWO TB skin tests, TWO MMR vaccinations(or Titer test) and TWO Varicella Vaccinations (or Titer test). Student presenting only one vaccine instead of two, or not having a titer test will not be allowed to enter orientation. Even if you have had chickenpox, a titer test must be presented.
Documentation required at volunteer orientation:
- proof of TWO MMR (Mumps, Measles, Rubella) vaccinations, or titer test showing positive immunity.
- proof of TWO Varicella (chickenpox) vaccinations, or titer test showing positive immunity.
- proof of TWO negative Tuberculosis skin tests, both having been administered within the past 365 days. If you test positive for TB, then you may bring a chest x-ray result from the current year. UCLA students may contact the Arthur Ashe Student Health & Wellness Center (310-825-4073) for appointments; non-UCLA students must go to their own physician or community clinic to obtain the necessary tests and records.
- The Tdap (Tetanus, Diphtheria, Pertussis) vaccination is highly encouraged for all volunteers. If you decide not to receive this vaccine, then a declination form must be turned in along with your other health paperwork (see the above section to download these documents).
***Things to Remember:
You must be invited to an orientation in order to attend. No latecomers are allowed into the session.
Bring with you all of the paperwork, fully completed and signed to the Check-In Time. Orientation Guide Quiz must also be completed. Please prepare to have a writing instrument ready to take notes.
The orientation location will be: Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Room B-130 (Tamkin Auditorium), Los Angeles fCA 90095.
HOLIDAY CLOSURES FOR 2013:The Volunteer Services Office will be closed during the following upcoming holidays:
|
Monday, January 21 |
|
Martin Luther King |
| Monday, February 18 | Presidents' Day | |
| Friday, March 29 | Cesar Chavez | |
| Monday, May 27 | Memorial Day | |
| Thursday, July 4 | Independence Day | |
| Monday, September 2 | Labor Day | |
| Monday, November 11 | Veteran's Day | |
| November 28-29 | Thanksgiving | |
| December 24-25 | Christmas | |
| December 31-January 1 | New Year's |
