A complete packet of forms must be sent to the service point of contact at the VA for the service in which you have chosen to rotate four weeks prior to the start of the rotation.  Failure to meet the four week deadline will necessitate choosing another rotation or having your rotation delayer.  See the Application Checklist for forms and complete all as required. 


The VA Packet may be scanned and emailed securely to the appropriate VA contact or mailed via US mail.



Application Checklist for Associated Health Trainees


Statement of Commitment and Understanding


Orientation Handbook – Signature Page

VACCHS Handbook

SF 61


VA Form 10-2850 Application for Health Professions Trainees 


Fingerprint Appointment Schedule

PIV Data Sheet

  • PIV Acceptable Forms of Identification (bring with you to Fresno)


    Fingerprint Request Form

  • Courtesy Fingerprint Form (for all appointments done outside of Fresno)

  • VA Computer Access Form

    Without Compensation (WOC) Assignment Letter (MS word doc) – to be filled in by staff at UCSF Fresno and signed by the student.  Return with VA packet.

    You will be asked to complete the OF 306 Declaration for Federal Employment and the USCIS I-9 Employment Eligibility Verification forms in the PIV Office at the Fresno VA.


    Contact List - Veteran’s Administration Health System, Fresno CA


    Michelle Nunez (559-225-6100 x 5417 or

    Heather Garner (559-225-6100 x 3789 or