UCLA Health Pre-Assigned Program
Please note: The Pre-Assigned Program will not be processing new volunteers in the month of June, please submit the completed and signed Pre-Assigned Letter BEFORE May 1st.
Forms and Modules to Complete
Below is a list of forms to print, sign, and create your volunteer packet.
In addition, you must complete the following training modules. You will need to generate a temporary ID to complete the online trainings (generate after first online training). Make note of the ID number after doing the first training as you will need to use the same ID for all FIVE (5) modules. Once you complete the online trainings, a certificate will be generated (HIPAA will generate a confidentiality form as well which you will need to sign and bring with you). Print the certificates and bring with you along with the forms above.
- HIPAA Privacy and Information Security Training (2 PAGES)
- CICARE Annual On-Line Training
- Safe Patient Handling Training
- Volunteer Services Training
- Radiation Safety: Hazard Awareness Training (Must use Internet Explorer)
- If you are experiencing issues with opening any trainings, please try using the Internet Explorer browser.
- If you are experiencing issues with completing any trainings, please do NOT pause or fast-forward any videos.
Please read over the requirements carefully as UCLA Health has very specific standards regarding immunizations. Attach a copy of your health records to your volunteer packet. Volunteer Services will shred and discard your health records after verifcation of immunizations. Below is a list of acceptable health documents:
Measles, Mumps, and Rubella (MMR)
- Medical documentation of TWO MMR vaccinations
- Medical documentation of ONE BLOOD TITER indicating immunity to MMR
- Disease history of MEASLES, MUMPS, and RUBELLA will NOT be accepted.
- Medical documentation of TWO VARICELLA vaccinations
Tuberculosis (TB) Screening
If you have always tested negative for TB, please provide:
- Medical documentation of a QuantiFERON-TB Gold (also known as QFT-G) blood test completed within the last 3 months.
If you have previously tested positive for TB, please provide:
- Documented proof of a positive QuantiFERON-TB Gold (also known as QFT-G) blood test (documentation of positive TB from any date will be sufficient).
- 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
- Signed Tdap declination if unable to provide medical documentation.
Influenza Vaccine (Flu) - If on-boarding between October 1-March 31
- Medical documentation of ONE Influenza (Flu) Vaccine administered AFTER August 1st of current calender year.