Forms

If you are NPH or Psychiatry staff, then you will need to submit the LOA email retention request via the Employee Experience Center. To access the form, please click below, complete the request, and submit the form.

Please note that non-exempt staff will not have access to this form.

Retain Email Access During Leave of Absence (LOA) Request Form

To follow up on the status, email NPIHARF@mednet.ucla.edu

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.