This page outlines the on-boarding requirements in which you must bring in-person to your On-Boarding Appointment. Please do NOT attend or sign up an on-boarding appointment if you are missing anything. Email us if you have any questions: CRV@mednet.ucla.edu

Please do NOT drop off or email your application packet to our office unless specifically instructed in your "Approval" email. "Approval" emails are required to proceed to the STEP 2.

Forms and Training Certificates must NOT be older than 6 months of your Onboarding Appointment, otherwise you will be asked to reschedule and recomplete them. 

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Paperwork and Forms | Training Certificates | Immunizations/Health Clearance Requirements

Paperwork and Forms

Below is a list forms you must PRINT, read over, complete, sign and BRING with you to your scheduled Clinical Health Sciences Onboarding Appointment.

1. Checklists: please fill out and bring the checklist to ensure that you have EVERYTHING COMPLETED BEFORE you attend an Onboarding Appointment. 
   1. Clinical UCLA Health Sciences Checklist for UCLA Students
   2. Clinical UCLA Health Sciences Checklist for NON-UCLA Students (or Previous UCLA Students)
2. Clinical UCLA Health Sciences Volunteer Coversheet and Acknowledgement
3. Clinical UCLA Health Sciences Volunteer Agreement
   
4. If you are a Current/Previous UCLA Paid Employee, please complete: Employee-Volunteer Agreement Form
5. Abuse Reporting Signature forms (3 pages)
6. Patent Policy (Please read the policy, you will be completing the Patent Acknowledgement form in-person during your appointment)
7. Sexual Harassment Information Sheet (Please read and keep for your reference)
8. Tdap Declination Form
9. Hepatitis B Declination Form
10. If you are under 18 years old, please complete:
    1. Minor Volunteer Forms
    2. Lab Only: Minor Volunteers in Labs and Shops Forms

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Training Certificates

Please complete the following training modules.

You will need to generate a temporary ID to complete the online training modules (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 six modules. Once you complete the online trainings, a certificate will be generated (HIPAA will generate a confidentiality form which you will need to sign and bring with you). Click Here for Step-by-Step Instructions.

PRINT the certificates and BRING them with you to your Onboarding Appointment:

1. HIPAA Privacy and Information Security Training
2. CICARE Annual On-Line Training
3. Safe Patient Handling Training
4. Volunteer Services Training
5. Radiation Safety: Radiation Hazard Awareness Training
6. Encryption Policy: Use of Mobile Devices and Removable Media Policy Attestation
   
   • If you are experiencing issues with opening any of the training modules, please try using the Internet Explorer browser.
   • If you are experiencing issues with completing any of the training modules, please do NOT pause or fast-forward any videos.
   • If you do not see your birth year when generating a TEMP ID, please use the most closest year available.
7. Laboratory Safety Fundamentals Training from UCLA EH&S (Only if you will be in a lab or with lab experiments)
   • Please login to Worksafe to complete your LSLC Training:
     • UCLA Students, login using your BOL User login credentials.
     • Non-UCLA Students, create a UCLA BOL login.

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Immunization/Health Clearance Requirements

Please BRING the following Proof of Immunizations/Health Clearances (medical documentations) to the Onboarding Appointment. Below is a list of acceptable health documents.

UCLA STUDENTS: UCLA Students are required to BRING medical documentation (proof) of their:

1. TB test results (see #1 below for more details)
2. Flu (Influenza) Vaccine (during Flu Season only, see #4 below for more details)
3. AND provide a Health Clearance Letter from UCLA Student Health Ashe Center. (NOTE: You will be asked to reschedule if you are MISSING ANYTHING.)
   • Please read the instructions on how to obtain that letter: Instructions for completing UCLA Health – Volunteer/SRP Health Clearance Requirement
   • NOTE: Your Health Clearance Letter from UCLA Student Health Ashe Center should already include clearances for immunizations #2, 3, 5, and 6.
   • NOTE: If you do NOT have UCSHIP, virtually requesting this letter will NOT incur charges if you have ALL health clearance items uploaded (#1-6).

NON-UCLA STUDENTS: Please BRING your medical documents of the following immunizations and health screening test results (#1-4). Proof of #5-6 immunizations require forms that must be signed instead.

Medical Documentation must:

• Be in the form of an OFFICIAL health/medical record, immunization record, printed/electronic version of a secure message from an official health record portal (i.e. Ashe Center, myUCLAHealth, etc.), or a copy of your lab results.
• Include your full legal name, your birthdate, and the provider/clinic information.
• NOTE: Please do NOT bring any doctor's note, hand written notes, hand written/printed letters NOT from a secure message from an official health IT portal, unofficial health/medical records, or illegible/untranslated documents.

Health Clearance Items

Please read over the requirements carefully as UCLA Health has very specific standards regarding health screenings/immunizations.

1. Tuberculosis (TB) Screening (Please read carefully)

• If you have always tested NEGATIVE for TB, please provide:
  • Medical documentation of a negative QuantiFERON Gold blood test result (also known as t-spot) completed within 3 months of your On-Boarding Appointment. 
  • If you are unable to obtain a TB blood test, please contact the program coordinator (CRV@mednet.ucla.edu) to request an exception to provide the Two-Step TB Skin Test Results.
• If you have previously tested POSITIVE for TB via BLOOD TEST (NOT SKIN Test), please provide:

  • Documented proof of a positive TB BLOOD TEST RESULT, (also known as QuantiFERON Gold or t-spot)(documentation of positive TB Blood Test from any date will be sufficient)

    AND

  • Medical documentation of a Chest Radiograph Report (Chest X-Ray) indicating negative TB results within 3 months of your On-Boarding Appointment.

2. Measles, Mumps, and Rubella (MMR)

• Medical documentation of TWO MMR vaccinations

OR

• Medical documentation of ONE BLOOD TITER indicating immunity (positive result) to MMR

NOTE: Disease history of MEASELS, MUMPS, and RUBELLA will NOT be accepted.

3. Varicella (Chickenpox)

• Medical documentation of TWO VARICELLA vaccinations

OR

• Medical documentation of ONE BLOOD TITER indicating immunity (positive result) to VARICELLA

NOTE: Disease history of VARICELLA (CHICKEN POX) will NOT be accepted.

4. Influenza Vaccine (Flu)

• Medical documentation of ONE Influenza (Flu) Vaccine administered AFTER August 1 of the calendar year. (Only required during Flu Season, effective November 1 to March/April.)
• Flu Vaccine Documentation is required for those attending On-Boarding Appointments between mid-October and April.

5. Tetanus, Diphtheria, Pertussis Vaccine (Tdap)

• Signed Tdap Declination Form (please complete this form even if you are immunized)

6. Hepatitis B Vaccine (Hep B)

• Signed Hepatitis B Declination Form (please complete this form even if you are immunized)