Submit proof (full name must be included with proof) of vaccinations and current TB test to our secretary (Due by Wednesday, October 19th, 2022, 11:59PM).

• If you have taken vaccinations at the Ashe Center: Log onto the Patient Portal on the Ashe Center's website.  Once you log in as a student with your UCLA ID, enter your date of birth and click "proceed."  You should then see a link that says "View my Ashe immunization record."  Click that link to access an organized page of your immunization records.  Take a screenshot of your "Immunization" page, and submit it to us using this google form. If you are having troubles with the form, you may send your screenshot directly to our secretary (secretary@flyingsamaritansatucla.org).

• If you do not want to use the Ashe Center website as proof of your immunizations or the Ashe Center website has not yet been updated with your records, you may use another form of proof, such as the yellow immunization record card or some other type of proof.  Once you decide what form of proof you want to use, SCAN a copy of your immunization records and submit it to us using this google form.  Again, if you are having troubles with the form, you may send your screenshot directly to our secretary.

• Please use this template to check that the records you are planning on sending to us meet our requirements.

Note: Our vaccine requirements include 1) Hepatitis B, 2) Measles, Mumps and Rubella (MMR), 3) Tdap (or Tdap Declination), 4) Varicella, 5) TB test or negative chest X-Ray, 6) Seasonal Flu Shot (optional; if you decline you must wear a mask) and 7) COVID-19 vaccination + booster.  The TB test or negative chest X-ray are valid through ONE YEAR of the result date! *Please note that if you want to take the swab test for TB test, it is a two-week process so do plan in advance!