VA Clearance Paperwork
Dear Medical Student
Welcome to the Ralph H. Johnson Veterans Affairs Medical Center (RHJ VAMC) and congratulations on your selection into your training program. Our mission is to honor America's Veterans by providing exceptional health care that improves their health and well-being. Our Vision focuses on being a patient-centered integrated health care organization by providing excellent health care, research, and education to its recipients.
The Department of Veteran Affairs requires you to provide and complete a few items which are outlined below. These elements must be completed at least two weeks prior to the start of your VA rotation. The forms, prerequisites and instructions can be found at our website http://www.charleston.va.gov/Welcome_Residents_and_Students.asp; “Resident/Student Information,” then follow the instructions.
· You must be fingerprinted no earlier than 120 days and no less than 14 days before your rotation. Fingerprinting is conducted by our Personal Identity Verification (PIV) Office in room B251 on the second floor. They are open Monday - Friday, 8:00am - 4:00pm, with the exception of Federal Holidays. Note: two forms of ID (Driver's License and Social Security Card or school ID) are recommended and are needed at the time of fingerprinting. In addition to being fingerprinted, you may also be photographed (neck up shot) for your VA ID badge(s).
2. TRAINING/FORMS/OTHER ITEMS:
Complete PIV Information Form.
Complete VHA Mandatory Training for Trainees (Follow the TMS instructions available on the web site)
Complete VA10-2850D, Application for Health Professions Trainees
Complete Optional Form 306, Declaration for Federal Employment
Complete Standard Form 61, Appointment Affidavit
Complete Employee Code of Conduct
Complete Infection Control Test (Review Ralph H. Johnson Infection Control procedures located at paragraph 4 of the above website)
Provide a copy of your last PPD (must be current within the last 12 months)
Provide a copy of your Basic Life Support card
Provide a copy of your Advanced Cardiovascular Life Support (ACLS) card
Note: ACLS card are only required for those who are expected to deliver moderate “conscious” sedation during the course of their clinical rotations.
3. COMPUTER TRAINING:
4. SUBMISSION OF ITEMS: Forward all items to Theresa Morgan, Affiliations Coordinator, Suite CC201, 109 Bee St, Charleston, SC 29401 or firstname.lastname@example.org or by fax to 478-274-5876. You can also drop these forms off after you are fingerprinted (room CC201, 2nd floor, follow the signs to the Learning Resource Center).
If you experience any difficulties or have questions, please feel free to contact VA Education Service at 843-789-7642 or email email@example.com. We look forward to working with you and enriching your clinical experiences.
JOSEPH F. JOHN, JR., MD