Forms & Policies

For internal use only, HS log in required.

• Form 5 Request Form 
• Form 5 – Business Entertainment Reimbursement Request Form 
• Form 5 – Guest Speaker Payments Guidelines 
• Form 5 – Host Certification 
• Form 5 – TEM Profile Instructions 
• Form 5 – Transmittal-Donation Template 
• Form 5 and Travel Regulations Requirements Spreadsheet 
• Travel Expense Form 
• Overnight and Airplane Travel Approval Form 
• G-28 Travel Regulations Policy 

For internal use only, HS log in required.

• BUS-43 Policy 
• HIPAA BA Appendix 
• Data Security & Privacy Appendix 
• Non-Disclosure Agreement – Mutual 
• Non-Disclosure Agreement – UC as Discloser 
• UC Purchasing Agreement 
• UC Terms and Conditions 
• Sole Source Justification Form 
• UC Source Selection & Price Reasonableness Form Completion Instructions 
• UC Source Selection & Price Reasonableness Form FAQ 
• Statement of Work 

For internal use only, HS log in required.

• BUS-43 Policy 
• Standard Spend Approval Matrix – Per IDA635 
• Unauthorized Purchases 
• Purchase Requisition (REQ) 
• W-9 Blank
• Request Form for User Access to Premier

For internal use only, HS log in required.

• Reprographics Services Job Request Form 
• Print Acquisition & Sustainability Management Policy: Print Policy
• Request form for User Access to Fontis

For internal use only, HS log in required.

• UCI Medical Center Value Analysis Policy 
• UCI Medical Center Value Analysis Committee Process Statement 
• UCI Medical Center Value Analysis Process Flow 
• EHR Revenue Cycle Trial Product Process Flow 
• Value Analysis One Page Summary Template 
• New Item or Conversion Checklist