Service Learning Checklist

Health Records

MMR Vaccines

  • Proof of two MMR vaccines. administered 4 weeks apart, OR Laboratory (serological) proof of immunity to measles and rubella.
  • These items will be records you’ll need to gather on your own. Either from the Student Health Care Center your family doctor or FL Health Dept

Chickenpox Vaccines

  • Documentation of immunity to Chickenpox (varicella) by one of the following:
    • Documentation of two varicella vaccinations. administered 8 weeks apart, OR
    • Laboratory (serological) proof of immunity, OR
    • Documentation of a history of varicella disease or herpes zoster (shingles”) by a licensed healthcare provider.
  • Gather from the Student Health Care Center, your family doctor or FL Health Dept

Tuberculosis

  • Click HERE for the Tuberculosis screening form. Fill out the top portion and return it to me.

Hepatitis B

  • Hepatitis B documentation of ONE of the following:
    • Documentation of completion of hepatitis B vaccine series.
    • Documentation of Hepatitis B surface antibody serology (optional, but recommended).
    • Declination of Hepatitis B vaccination completed.
  • Gather from the Student Health Care Center, your family doctor or FL Health Dept

Tdap

  • Tetanus/ Diphtheria/Pertussis: Documentation of one dose of tetanus/diphtheria/pertussis (Tdap) vaccination within the past 10 years.
  • Gather from the Student Health Care Center, your family doctor or FL Health Dept

Flu Shot OR Flu Declination Form

COVID-19 Vaccination OR Vaccine Education Form

  • Proof of vaccination of the COVID-19 vaccine series OR Completion of UF Health’s “Vaccine Educate and Offer Campaign” Form: CLICK HERE

Trainings

HIPAA

  • HIPAA & Privacy – General Awareness
    • follow the link provided to myTRAINING. When completed, send the pdf of the “diploma” to me
    • HIPAA Training

Service Orientation

  • “UF Health Volunteer Orientation Versional”
    • follow the link provided to myTRAINING. When completed, send the pdf of the “diploma” to me
    • Volunteer Orientation

HIV/AIDS Training

  • “HIV/AIDS Education for Healthcare Workers (NCO-095-07012027)”
    • follow the link provided to myTRAINING. When completed, send the pdf of the “diploma” to me
    • HIV/AIDS Training

Forms and Documents

Background Check

  • Criminal Background Check
    • Can be ordered online and mailed to you or picked up at the station. Scan or photograph and send to me.
    • Enter YOUR information as the “requestor”
    • Enter “N/A” in the Police Report # / Case Number field
    • GPD background check request

Health Insurance

  • May be waived for students demonstrating hardship
  • Scan or photograph your health insurance card and send to me

Security and Confidentiality form

Code of Conduct