Visitor – Extending the Visit

Visiting Graduate Researcher or Visiting Scholar

Please answer the following questions to help us complete your DS-2019. All fields are required, so please enter "N/A" if one does not apply to your situation.
* indicates required field

Visiting Graduate Researchers are students currently enrolled in a graduate program. If you are a registered student, you must apply as a Visiting Graduate Researcher.

Permanent Address Outside of US

Mailing Address (may be within or outside of US)

If currently enrolled as a student, please specify the following:

If employed, please specify the following:
If you answer yes, you must attach a copy of your previous J-1 and/or J-2 visas below (see Required Documents section).
For the funding sources below, list financial support for the entire period covered by this form, and specify in US Dollars.

UCLA Department budget, grant, etc.

Please include appropriate financial document when emailing your other required documents.

Other organizations/institutions in the US or abroad
Please include appropriate financial document when emailing your other required documents.

Personal funds
Please email a copy of your bank statements in English.
Copy of Dependent's passport is required

For each dependent, list the following:
  • Last name, first name (as it appears on their passport)
  • Relationship
  • Date of birth (MM/DD/YYYY)
  • City of birth
  • Country of birth
  • Country of citizenship
  • Country of permanent residents
  • Email
  • Phone number

J-1 visitors at UCLA (other than those visitors who fall under the designated groups below) are required to enroll OR opt out of the Visiting Scholar Injury and Sickness Insurance Plan (VSISP) through Garnett-Powers & Associates. In order to opt out of the VSISP plan, J-1 visitors are required to show proof of health insurance with the following minimum coverage:
  • All $100,000 per accident or illness.
  • An annual deductible not exceeding $250.
  • $50,000 minimum coverage for expenses associated with the medical evacuation to the visitor’s home country. (international only)
  • $25,000 minimum coverage for expenses associated with repatriation of remains to exchange visitor's home country. (international only)
  • Pre-existing conditions must be covered after a 12-month waiting period.
  • Coverage may include a provision for maximum 25% coinsurance or co-payment paid by the visitor. Coinsurance must allow for customary & reasonable charges in US dollars, not equivalent cost for services in home country.
  • Coverage cannot exclude benefits for perils inherent to the activities of the program in which the visitor participates.
  • Policy must be underwritten by an insurance corporation meeting the US Department of State rating requirements or backed by the full faith and credit of the visitor's home country government, designated sponsor, or exchange visitor's employee group plan.
Information regarding eligibility, requirements, enrollment and the waiver approval process can be found on the Garnett-Powers site at VSISP enrollment confirmation will be sent to the J-1 visitor by email. Visitor must print and bring for check-in. Those approved for the waiver, must bring their waiver confirmation and proof of medical insurance used to waive.


As an international J-1 scholar or non-degree student you are required to complete a J-1 orientation per U.S. Department of State regulations. UCLA jPATH Orientation is composed of several components that must be completed by the end of week 2 of your UCLA program. You will receive information about jPATH when issued a DS-2019 form, but you should be aware that failure to complete jPATH may also lead to the cancellation of your J-1 visa status since orientation is a U.S. Department of State requirement. More information about the program can be found here.
If you have difficulty uploading documents, please email them to

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Maximum file size: 1mb.

(see DS-2019 Instructions for requirements)

(see Exchange Visitor Regulation Guidelines)

(Form is available here)

(See VGR website for more details)

If you encounter any errors submitting this form or completing the CAPTCHA, please complete this form and email it to along with the required documents listed above.