{"id":8872,"date":"2020-10-27T04:37:44","date_gmt":"2020-10-27T04:37:44","guid":{"rendered":"https:\/\/dhs.lacounty.gov\/harbor-ucla-medical-center\/?page_id=8872"},"modified":"2024-10-01T07:16:24","modified_gmt":"2024-10-01T14:16:24","slug":"employee-health-services-forms","status":"publish","type":"page","link":"https:\/\/dhs.lacounty.gov\/harbor-ucla-medical-center\/work-or-partner-with-us\/employee-health-services-forms\/","title":{"rendered":"Employee Health Services Forms"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text]<\/p>\n<div id=\"skin-contentWeb20\">\n<div class=\"Web20freeForm\">\n<div id=\"Web20freeFormItem\">\n<p><span style=\"font-size: small;\"><span style=\"font-family: arial,helvetica,sans-serif;\"><strong>Information Sheet<\/strong><\/span><\/span><\/p>\n<ul>\n<li><span style=\"font-size: small;\"><span style=\"font-family: arial,helvetica,sans-serif;\"><a href=\"https:\/\/apps.dhs.lacounty.gov\/cef\">Non County &#8211; For use by non-County workforce members to obtain employment within Health Services.<\/a><\/span><\/span><\/li>\n<\/ul>\n<p><span style=\"font-size: small;\"><span style=\"font-family: arial,helvetica,sans-serif;\"><strong>Pre-placement or Pre-assignment Health Clearance Packet<\/strong><\/span><\/span><\/p>\n<ul>\n<li><span style=\"font-size: small;\"><span style=\"font-family: arial,helvetica,sans-serif;\"><a href=\"https:\/\/file.lacounty.gov\/SDSInter\/dhs\/1063683_E2-Pre-PlacementTBHistoryEvidenceofImmunityPacket.pdf\">Non-County &#8211; Non-County- For use by contractor staff, affiliate students, volunteers and vendors who are not Health Services &#8211; county employees. In addition, to be used for other county employees working in Health Services facilities such as DPH, DMH, Sheriff and Coroner.<\/a><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<p>[\/vc_column_text][vc_column_text css=&#8221;&#8221;]<iframe loading=\"lazy\" title=\"How To Video\" src=\"https:\/\/lacountymediahost.granicus.com\/MediaPlayer.php?clip_id=11271&amp;starttime=undefined&amp;ampembed=1&amp;starttime=0&amp;autostart=0&amp;embed=1\" width=\"960\" height=\"540\" frameborder=\"3\" aria-label=\"How To Video\" data-mce-fragment=\"1\"><span data-mce-type=\"bookmark\" style=\"width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><span data-mce-type=\"bookmark\" style=\"width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\"><\/span><\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text css=&#8221;&#8221;]<\/p>\n<div id=\"skin-contentWeb20\">\n<div class=\"Web20freeForm\">\n<div id=\"Web20freeFormItem\">\n<p>&nbsp;<\/p>\n<p>Annual Health Screening Packet<\/p>\n<ul>\n<li><span style=\"font-size: small;\"><span style=\"font-family: arial,helvetica,sans-serif;\"><a href=\"https:\/\/file.lacounty.gov\/SDSInter\/dhs\/1069387_2017AnnualScreening.pdf\">Non-County &#8211; For use by non-County workforce members to obtain annual health screening clearance. Health screening clearance must be obtained each year on the same month of assignment date with Health Services.<\/a><\/span><\/span><\/li>\n<\/ul>\n<p><span style=\"font-size: small;\"><span style=\"font-family: arial,helvetica,sans-serif;\"><strong><a href=\"https:\/\/file.lacounty.gov\/dhs\/cms1_202855.doc\">EHS Policies<\/a><\/strong><\/span><\/span><\/p>\n<p style=\"margin-left: 20.0px;\"><a href=\"http:\/\/file.lacounty.gov\/SDSInter\/dhs\/1101856_DHSPOLICY705.001HEALTHSCREENINGNON-COUNTYWORKFORCEMEMBERS020116.pdf\"><span style=\"font-size: small;\"><span style=\"font-family: arial,helvetica,sans-serif;\">Health Screening &#8211; NonCounty WFM Policy No. 705.001<\/span><\/span><\/a><\/p>\n<p><span style=\"font-family: arial,helvetica,sans-serif;\"><strong><span style=\"font-size: small;\">Frequently Asked Questions<\/span><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"font-family: arial,helvetica,sans-serif;\"><span style=\"font-size: small;\"><a href=\"https:\/\/file.lacounty.gov\/SDSInter\/dhs\/1039654_EHSFAQ.pdf\">FAQ<\/a><\/span><\/span><\/li>\n<\/ul>\n<p><strong><span style=\"font-family: arial,helvetica,sans-serif;\"><span style=\"font-size: small;\">Health Clearance Requirements<\/span><\/span><\/strong><\/p>\n<ul>\n<li><span style=\"font-family: arial,helvetica,sans-serif;\"><span style=\"font-size: small;\"><a href=\"https:\/\/file.lacounty.gov\/SDSInter\/dhs\/1039655_EHSRequirements.pdf\">EHS Requirements<\/a><\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text] Information Sheet Non County &#8211; For use by non-County workforce members to obtain employment within Health Services. Pre-placement or Pre-assignment Health Clearance Packet Non-County &#8211; Non-County- For use by contractor staff, affiliate students, volunteers and vendors who are not Health Services &#8211; county employees. In addition, to be used for other county employees working [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":9000,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_oasis_is_in_workflow":0,"_oasis_original":0,"_monsterinsights_skip_tracking":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[],"tags":[],"class_list":["post-8872","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Employee Health Services Forms - Harbor-UCLA Medical Center<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dhs.lacounty.gov\/harbor-ucla-medical-center\/work-or-partner-with-us\/employee-health-services-forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Employee Health Services Forms - Harbor-UCLA Medical Center\" \/>\n<meta property=\"og:description\" content=\"[vc_row][vc_column][vc_column_text] Information Sheet Non County &#8211; For use by non-County workforce members to obtain employment within Health Services. 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