UCLA School of Nursing Clinical Health Clearance Checklist

This is for Enrolled students only

In order to practice in clinical settings, it is necessary that you meet all Centers for Disease Control required health requirements, as well as other requirements as stipulated by the clinical agencies themselves. YOU WILL NOT BE ALLOWED TO ENTER THE CLINICAL SETTINGS IF YOU HAVE NOT MET ALL NECESSARY CLEARANCE REQUIREMENTS.

Documentation of completion of the following must be received by Belinda Huntly ( (BS and MECN) as soon as possible and no later than:

Wednesday,  November 1, 2018 for BS / MECN / MSN Students

  • Current American Heart Association only CPR Basic Life Support (BLS) (class only) certification for healthcare providers (a copy of the front & the back of the signed card)
  • Current Certificate of HIPAA Privacy and Security training: Go to Under – Workforce Required Training Select –HIPAA Privacy and Information Security Training for New Workforce Members
  • Click the link below to begin the training: HIPAA Privacy and Information Security Training for New Workforce Members – After you answer the 11 questions quiz – print out the certificate and submit to Belinda Huntly
  • Copy of a current respirator Fit Test* (Belinda Huntly will email you information regarding Fit Test classes.)
  • Copy of a current RN License** (a copy of the front & the back of the signed license – only for MSN students)
  • Background Check – Order through CastleBranch – Click on the red button "Place Order"; click on "Please Select"; click on "School of Nursing"; Click on your cohort; Select the first selection which includes Background Check+Medical Document Manager+Future Focus – total cost for all is 77.00 dollars
  • Copy of your Ashe Center Student Health Immunizations list showing your clinical documents have been verified by the Arthur Ashe Student Health and Wellness Center and you are compliant with all health clearance requirements listed below – this list will be at (click on Services, Health Clearance, Professional School Health Clearance and Immunizations) after your documents are verified by the Ashe Center.  Ashe Center’s health clearance process


The following health clearance items must also be completed, verified by the UCLA – Arthur Ashe Student Health & Wellness Center, and your Immunizations listing received by Belinda Huntly as soon as possible and no later than the date listed above in paragraph two. 

In order to complete all of the requirements by the deadline, we recommend that you start the Hepatitis B vaccine series as soon as possible. 

  • Current Physical Exam – A complete Physical Exam and a Statement of Good Health from your healthcare provider (on letterhead or a prescription pad) that you are in good health and able to perform the basic duties of a nurse
  • Documentation of a current Seasonal Influenza vaccine
  • Documentation of a (TDAP) tetanus/diphtheria/adacel/pertussis vaccine
  • (Note: the tetanus/diphtheria vaccine is unacceptable without the pertussis)
  • Documentation of 2 Negative Tuberculosis Skin Tests (PPD), at least one week and no more than 6 months apart. Students with a positive PPD must obtain documentation of a Chest X-ray or a negative T-Spot or QuantiFERON®-TB test (QFT)
  • Documentation of a Hepatitis B series (series of three vaccines) and a positive titer. At a minimum, the first 2 doses must be completed by 11/1/2017.
  • Documentation of a positive Measles titer
  • Documentation of a positive Mumps titer
  • Documentation of a positive Rubella titer
  •  Documentation of a positive Varicella Zoster (chicken pox) titer

  *Fit Test – Documentation required when entering for MSN and PM students

**RN License – Required for MSN, PM, PHD & MBA/MSN students only

If you have questions, please contact Belinda Huntly,, 5th Floor, Room 5-946, School of Nursing, Factor Building, Fax:  310-206-3241.

Additional Requirements: Belinda Huntly will notify you by email if the clinical site you are assigned to has additional health clearance requirements.  Some clinical sites require a Urine Drug Screen and/or a Fire Card.