Care Extender Forms

Forms for UCLA Care Extender Program

The Leave of Absence form should be submitted to the Leave of Absence Coordinator, Benjamin Chiang, at The Change of Information form, Extension Request form, Reorientation Quiz, and TB Questionnaire should be submitted to the Administrative/Extension Coordinator, Alexis Sherer, at The Inactivation/Completion Request form should be mailed along with your volunteer ID badge to the Care Extender Office.