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Forms

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Please find your category below to access, utilize, and print the applicable forms and documents.

J-1 Visas

Notice to department staff prior to completing DS-2019 Request Form
FOR INITIAL ENTRY:

  • If your Exchange Visitor (EV) has been in the U.S. as a J-1 Exchange Visitor within the last 12 months for a period exceeding 6 months, he/she is not eligible to enter the U.S. as a J-1 research scholar or professor to start a new program.
  • If your EV has applied for permanent resident status (green card), he/she is not eligible for initial entry of J status.

FOR EXTENSION/TRANSFER:

  • If your EV has applied for permanent resident status (green card), he/she is not eligible for extension or transfer of J status.
  • If your EV has been granted a waiver by the U.S. State Department, he/she is not eligible for extension or transfer of J status.

Instructions 
DS-2019 Request Form - Dept. Section (MS Word Template) 
DS-2019 Request Form - Employee Section (MS Word Template) 
Mandatory Health Compliance Form 
Certificate of Medical Insurance for Postdoctoral Scholars 
International Physician Attachment

Supporting Documents Checklist 
J-1 Checklist 
P39 for Sevis 
P39 for Visa and Licensing Unit
Certification of English Language Proficiency 
J-1 Insurance Compliance Certification (transfers and extensions only)
J-1.Interdepartmental Request Form


H1-B Visas

Please contact the Dashew Center for International Students & Scholars (DCISS) for forms and fees.

H-1B Policy for the School of Medicine


TN Visa Application

Please contact the Dashew Center for International Students & Scholars (DCISS) for forms and fees.


O-1 Visas

To be completed by DGSOM Department and returned to the DGSOM Visa and Licensing Office. Please include a one-time review fee of $400. UCLA departments may use a Recharge Request Form (P-39) or personal check made payable to the U.C. Regents.

Guidelines & Application
Required Documents
Export Control Certification
Sample Appointment Letter
Sample Payment of Fees Letter


Permanent Residence

To be completed by DGSOM Department and returned to the DGSOM Visa and Licensing Office. Please include a one-time review fee of $400. UCLA departments may use a Recharge Request Form (P-39) or personal check made payable to the U.C. Regents.

Guidelines and Application
Sample Appointment Letter
Sample Payment of Fees Letter


Special Programs

Contact the Visa & Licensing Office to obtain the forms

Limitations and Restrictions for Section 2111
2111 Department Letter to Request Section 2111 (MS Word Template)
2111/2113 Administrative Processing Sheet (MS Word Template)

 

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