Forms

Requesting CareConnect Access for Research

In order to apply for CareConnect – Research access, you must have an active Mednet email account. If you do not have one, please request one by clicking here:  Access Request Form for Staff.

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.