Forms

Access Request Form for No UCPath Appointment in Semel/Psychiatry/NPH

Click the access category you are requesting

Affiliate

DO NOT select Affiliate category for a UCLA student registered with UCLA Health Volunteer Services – select Volunteer category instead.

A UCLA student or staff who has sponsorship from Semel/Psychiatry/NPH AND may need VPN access.

Contractor

Meets BFB-BUS-77 Independent Consultant Guidelines
https://policy.ucop.edu/doc/3220485/BFB-BUS-43
https://policy.ucop.edu/doc/3600670/Independent Contractor

Collaborator

User who is a student or staff in other universities and is part of an IRB.

Intern

User is enrolled as a student in a non-UC campus.
Need access to participate in training or internship.

Volunteer

Registered with UCLA Health Volunteer Services.

Reach out!

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You may send an email to NPIHDesktop@mednet.ucla.edu or you can fill out this form to get in touch with one of our team members.

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Attention!

Applying for mednet vpn access?

Only supervisors/managers should complete this form!

Click here to proceed

Attention!

Applying for access request with no UCPath appointment?

Enter user's name.

Please SELECT ONE of the categories below that the user belongs to.

Note: If none of these apply to you, then you should not fill out this form.

For a definition of each category, hover over here!
CATEGORY DEFINITION
Affiliate A student or staff in non-UCLA Health department.
Contractor Meets BFB-BUS-77 Independent Consultant Guidelines https://policy.ucop.edu/doc/3220485/BFB-BUS-43 https://policy.ucop.edu/doc/3600670/Independent Contractor
Collaborator User who is a student or staff in other universities and is part of an IRB.
Intern User is not enrolled in any UC campus as student. Need access to participate in training or internship.
Volunteer Registered with UCLA Health Sciences Volunteer Program https://www.uclahealth.org/volunteer/ucla-health-sciences-volunteer-program

just making sure you're not a robot

Attention!

Applying for Research careconnect access?

Please contact Semel Research CareConnect at SemelResCon@mednet.ucla.edu.