Student Application Process
Applicants should be referred to the UCLA visiting student webpage for applications and instructions.
No designated parking is provided for students. One meal a day is provided to fourth year students completing a course at the 300 level and above. Please see the Student Section-link to the left for information on check-in times, housing, and parking for medical students.
Application Checklist for Coordinators - UPDATED!
Applications must be received from the course department with original documents in the GME office 4 weeks prior to the start of a course -no exceptions. Incomplete or incorrect applications will be returned to the department.
Click here for Fourth Year Student Clerkship Coordinator Check List. Note - Checklist MUST be included when application is submitted to the GME office.
All students must obtain live scan and clear Employee Health prior to reporting to their respective programs. For UCLA Students, this should be done at least two weeks prior to the start of your Harbor rotation. All non-UCLA Students (i.e. Visiting Students/Externs) must submit their completed E2 form to the program coordinator who will submit to the GME office along with their clerkship application. All subinterns who have cleared Live Scan and Employee Health must first report to the GME office to sign in and then proceed to Human Resources (Medical Foundation Professional Building, 21840 South Normandie Ave, Suite 800), to obtain their I.D. badge. Click Here to download the Employee Health form and accompanying documents. Once complete, UCLA students must fax or email to Erika Sweet in Employee Health at 310/222-5326 or esweet@dhs.lacounty.gov.
Note - if you have already been live scanned and cleared Employee Health at another LA County site, you may not have to be cleared again at Harbor. Please contact Human Resources at 310/222-3241 to verify your live scan status prior to obtaining your live scan.
There are three options for live scan:
Option 1 - Live Scan may be performed at the Harbor-UCLA Human Resources office (Medical Foundation Professional Building, 21840 South Normandie Ave, Suite 800) or at one of our other County locations. Click here for details on using Option 1 for Live Scan. Note - all arrangements for Live Scanning at another facility should be made through Saundra Whitfield, HR Manager at 310/222-3241 or at swhitfield@dhs.lacounty.gov.
Option 2 - Live Scan may be performed at a "public" Live Scan agency. Click here for details on using Option 2 for Live Scan.
Option 3 - Ink Fingerprinting - Hard Card
Fingerprinting may be performed by a local law enforcement agency. With this option, the applicant is responsible for paying the rolling fees charged by the agency. In order to initiate this process, the applicant must contact the DHS Background Verification Unit (BVU) at 323/869-8242. The DHS BVU will mail a fingerprint card, the pre-employment packet, and the applicable instructions for completing the process. Since this process is conducted via standard mail service, we recommend that applicants choosing this option begin at least 2-4 weeks prior to their scheduled start date.
Code of Conduct
All students must complete LA County's Code of Conduct exam. Please submit the completed exam and acknowledgment form along with the rest of the application packet. Code of Conduct -Compliance Awareness Training: Study Guide, Test
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| Program Eligibility:
Must be 4th year student at the time of clerkship (6th year for foreign student) |
North American Student Elective Application Part I form:
Part I requires school seal,
bottom portion complete, an original signature (stamps not acceptable), and application payment confirmation number. |
| North American Student Elective Application Part II form: Part II requires original signatures from Course Instructor and Department Chairman (stamps not acceptable) |
| UCLA Photo ID application form:
Must include a 2x2 photo attached (foreign students require two photos. Complete top/bottom postion of I.D. form. |
| Transcript (unofficial transcript unacceptable):
Must indicate all prerequisites and successful completion of the course.
Letter from the course director will be accepted as verification of successful completion. |
| Letter of Recommendation or Good Standing:
Must include supervised clinical experience |
| UCLA Health Statement form:
Requires signature of a licensed physician
TB Immunization verification within the year of rotation - no exceptions. TB report if skin test positive. |
DHS Employee Health Clearance form must be completed prior to rotation. Click here
to download the form. Please fax or email the completed form to Erika Sweet in Employee Health at 310/222-5326 or esweet@dhs.lacounty.gov. |
| Health Insurance:
Requires proof of personal health insurance coverage during the clerkship.
Must include copy of medical insurance card |
Payment: Application Fees must be paid electronically by the student before applying. There should not be any checks enclosed with applications. Instead, students are to pay online and put their "Payment Confirmation Number" on the application. Before any approvals are sent, UCLA will verify the application fee has been paid. Fees are $150 for North American Students; $450 for International Students.
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| HIPAA Certification:
UCLA HIPAA Certification |
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