ACTRI Clinic Access Request Form

Requirements for Access to the ACTRI Clinic for New Users

To ensure that all new ACTRI clinic users are well-acclimated to our workflows, mandatory orientations are required before access is granted. These trainings cover:
- Clinical Conductor (Scheduling)
- ACTRI Front Desk Procedures
- ACTRI Nursing Staff Processes
- ACTRI Coordinator Responsibilities
The total estimated training time is approximately 8 hours, which may be divided into multiple sessions depending on your role and availability.

1. ACTRI Front Desk & Nursing Staff
- Orientations are held Tuesday through Thursday, with sessions available at 8:00 AM and 12:00 PM.
- Sessions begin at the front desk and continue with the clinic nurses.
- Please allow up to 3 hours for completion.
- A member of the ACTRI Nursing team will contact you to schedule based on your availability.
2. Clinical Conductor (Scheduling)
- Training is held Thursdays at 2:30 PM.
- David Marrufo will reach out to coordinate this session with you.
3. ACTRI Coordinator
- Availability for this training varies.
- A member of the ACTRI CRC team will contact you to coordinate scheduling.
To initiate the onboarding process, please submit the form below. Access will only be granted after all three trainings are completed, unless an exception has been approved.

If you have any questions or need assistance, feel free to contact us at CTRI-Clinic@health.ucsd.edu.
Are you completing this request for someone else?*

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Please do not continue if you are attempting to complete this request form for someone else. The request form is created in a way where each response is specific to an individual. Instead, we recommend that you forward the link below to the person who needs access and have them complete it for themself.

https://ucsd-actri.jotform.com/211674870051857

Please contact ctri-clinic@health.ucsd.edu for any questions regarding the form.

-- Clinical Lab Access Section
Clinic Lab Access:

Complete the following three courses here UC Learning Center :
1. Biosafety: Bloodborne Pathogens Training and Annual Refresher
2. Annual Laboratory Hazards Training
3. UC Laboratory Safety Fundamentals
Example Certificates: https://ucsdcloud-my.sharepoint.com/:f:/g/personal/mgaytan_ucsd_edu/EjlUBdjoavpFihm2skWdBp8BynDBLBK9fGIpRJN43ZWZ0w?e=y9iyCQ
Biosafety: Bloodborne Pathogens Trainings and Annual Refresher*

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Biosafety: Bloodborne Pathogens Trainings and Annual Refresher completion date

MonthDayYear
Date
Annual Laboratory Hazards Training*

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Annual Laboratory Hazards Training completion date

MonthDayYear
Date
UC Laboratory Safety Fundamentals*

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UC Laboratory Safety Fundamentals completion date

MonthDayYear
Date