UCSF Recovery Operations Center (ROC) Event and Meeting Request Form

UCSF Recovery Operations Center (ROC) Event and Meeting Request Form

Event and Meeting Request Form for Use During the COVID-19 Pandemic

Revised: May 19, 2023

Effective for events and meetings planned for October 1, 2021

and later, and until further notice.

This form should be completed by the UCSF staff person or faculty member responsible for the event.

This form is a request to conduct university-sponsored or hosted in-person, onsite and offsite conferences, meetings, and events of 100 people or more.

NOTE: Food servers and other staff must be included in the total number of people attending.

As the responsible UCSF official, I attest that all on-site affiliates will follow the UCSF Guidelines for face covering and digital screening as described at https://coronavirus.ucsf.edu/campus-protocols

I attest to follow Work on Site Guidelines*

As the responsible UCSF official, I attest that I will comply with all capacity and space recommendations noted on the UCSF COVID-19 webpage on https://coronavirus.ucsf.edu/events.

I attest to follow capacity recommendations*

Event Type*

Fill out only for proposed events or meetings with over 100 people (including servers and event staff) or if you are unsure how many people will attend

Select or enter value

Event Name*

Event Date(s)*

Event Start and End Times*

Event Location*

Please specify name of venue or room(s) you plan to use. (This form does not reserve venue or rooms, which are usually required for conference center and special use areas). If venue is offsite, please include the city and state.

Total number of people scheduled to attend*

Event Location Occupancy Limits*

What is the maximum capacity of the space/room you are using

Describe the attendees in the venue space*

Will there be members of the general public at this event? Please describe the number of attendees in each category: UCSF Faculty, Staff, Students, Vendors, General Public, Other - Please specify.

Event Description*

Responsible UCSF Official*

Event Planner's Name

Responsible UCSF Officials Email*

Event Planner's Email

Responsible UCSF Official's Department Name*

UCSF Onsite Safety Monitor*

Please provide if different than above named Responsible UCSF Official or state that it is the same person as noted above

UCSF Onsite Safety Monitor's Email*

I attest that my Department Head, Chair or Dean are aware of and have approved this event*

Name of Department Head, Chair or Dean*

Email of Department Head, Chair or Dean*

Send me a copy of my responses

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