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Forms to Bring To Check-In

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.

 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 (do not print):

 Forms to Print, Complete and Bring with You on Orientation Day:

Proof of Immunization Forms

AS OF OCTOBER 1, 2014, IN ADDITION TO THE IMMUNIZATION REQUIREMENTS NOTED BELOW, PROOF OF 2014-2015 FLU VACCINATION IS REQUIRED IN ORDER TO VOLUNTEER.

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). Students 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:

Measles, Mumps, and Rubella (MMR)

  • Medical documentation of TWO MMR vaccinations

     OR

  • Medical documentation of ONE BLOOD TITER indicating immunity to MMR
  • Disease history of MEASELS, MUMPS, and RUBELLA will not be accepted.

 Varicella (Chickenpox)

  • Medical documentation of TWO VARICELLA vaccinations

      OR

  • Medical documentation of ONE BLOOD TITER indicating immunity to VARICELLA
  • Disease history of CHICKENPOX will not be accepted.

Tuberculosis (TB) Screening

If you have always tested negative for TB, please provide:

  • Medical documentation of TWO SEPARATE TB skin tests, One TB test must be completed within the last 3 months. The other TB test must have been completed within the last 12 months. (NOTE: It's UCLA Health policy that you receive two separate TB skin tests and no exceptions will be granted.)

      OR

  • Medical documentation of a QuantiFERON Gold (also known as t-spot) blood test completed within the last 3 months.

If you have previously tested positive for TB, please provide:

  • Documented proof of a positive TB skin test or positive QuantiFERON Gold (also known as t-spot) blood test (documentation of positive TB from any date will be sufficient)

      AND

  • Medical documentation of a chest radiograph (chest x-ray) report within the last 3 months.

Tetanus, Diphtheria, Pertussis Vaccine (Tdap)

  • Medical documentation of Tdap vaccination

      OR

  • Signed Tdap declination if unable to provide medical documentation.

 ***Things to Remember:

You must be invited to an orientation in order to attend. You must sign up on the sign up page provided.  All paperwork must be in blue or black ink and on white paper. No latecomers are allowed into the session.

Check-In Date and Time will be sent you.

The orientation location will be: UCLA Medical Center, Santa Monica, 1250 16th Street, Santa Monica CA 90404. Room number varies for each orientation you will be notified of it before your orientation date.