Forms to Bring To 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.

Training Materials to Study (Do not print):

• Orientation Guide
• Volunteers' Assignment List
• Dress Code

Forms to Print, Complete and Bring with You to Check-In Day:

• Coversheet and Acknowledgement Form
• Volunteer Agreement
• Abuse Reporting Forms (Signature Forms)
  • Elder
  • Child
  • Domestic
• Volunteer Service Description
• Tdap Declination

IMPORTANT: You will need to generate a temporary I.D. to complete the following On-line training modules. Please note that the HIPAA training has two pages to print, along with a required signature.

• HIPAA Privacy and Information Security Training
• CICARE Annual On-Line Training
• Safe Patient Handling Training
• Volunteer Services Training
• Radiation Safety Training 

What immunizations are required to volunteer?

The following below are the immunizations required in order to volunteer. Applicants must bring a copy (they will not be returned) of their immunization records to Check-In Day (see page 8 in the Orientation Guide listed above.) UCLA has very specific requirements for immunizations in order to volunteer. Applicants must provide proof for all of the following below. Please make note of which immunizations require TWO vaccinations, and/or provide proof of a blood indicating immunity.

1. 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.

2. 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.

3. 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).

                                       AND

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

4. Tetanus, Diphtheria, Pertussis Vaccine (Tdap)

• Medical documentation of Tdap vaccination

OR

• Signed Tdap declination if unable to provide medical documentation.

5. Flu Vaccination

• Only applicable during flu season.

Things to Remember:

• You must be invited to a check-in day or orientation in order to attend. A sign up page will be provided.
• Please bring all of the required paperwork to check-in. Paperwork must be in blue or black ink on white paper. 
• Orientation location will be: UCLA Medical Center, Santa Monica, 1250 16th Street, Santa Monica CA 90404.
• Room numbers vary for each orientation and you will be notified before your orientation date.
• No latecomers are allowed into the orientation sessions. Please plan ahead to arrive 15-30 minutes prior to allow for parking if applicable.