Forms
Requesting Access for Physician & Faculty (MDs only)
Please read the following disclaimers before continuing:
Disclaimer 1:
New AD user account requests require the completion of HIPAA Privacy and Information Security training. If the training is not completed at the time this request is submitted, AD account establishment will be significantly delayed. CITI HIPAA certificates are not acceptable under UCLA Health. Please ask user to visit the following link to complete the UCLA HIPAA training as soon as possible: https://uclahs.fyi/HIPAAtrainingOCR.
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