All institute training opportunities require the submission of this form, including the upload of the institute's Appointment Requisition & Assignment Description.

The Appointment Requisition & Assignment Description is required for all students/interns and similar volunteers, detailing whether the assignment will be involved with LA County DHS facilities, patients, or IT systems; have exposure to hazardous agents; or involve working with animals.

Please note that additional lead time will be required to obtain a clearance to start an assignment if these factors are involved in the assignment. Such lead time may take up to several weeks to obtain clearance to start an assignment.

All trainees that are admitted to the institute, whether under a general internship, an institute program (e.g., Summer Fellows Program, PhD Program), or other training opportunity, are registered as students based on an academic year divided into four academic quarters.

Once onboarded, students must register for every quarter they matriculate at the institute. They will be notified by the Office of Education to do so, but you or the direct supervisor of an intern may be contacted if the student does not register nor indicate that they completed their training.

The institute’s academic year is as follows:

  • Begins October 1
  • Ends September 30
  • Comprised of four academic quarters
    • Fall (October 1 – December 31)
    • Winter (January 1 – March 31)
    • Spring (April 1 – June 30)
    • Summer (July 1 – September 30)

The periods in which a trainee interns at the institute may vary within this academic year, i.e. their start and end dates do not need to align with the academic quarter. However, the trainee must be registered for all quarters that comprise their training period, with a two-week grace period on either side of an academic quarter.


  1. A trainee who begins an internship on June 15 and exits on January 20 of the following year is registered for a summer, fall, and winter quarter.
  2. A trainee who begins an internship on June 1 and exits on December 15 is registered for a spring, summer, and fall quarter.

If the form is not visible below, click the button to go to the form directly to complete and submit it.