REQUIRED VA DOCUMENTS

The below documents are required for students rotating in Dermatology, Radiology, Neurology and Psychiatry Clerkships.  The following forms are required of ALL medical students completing elective rotations at the VA:

* Faxed copies of completed forms are not acceptable.  Original signatures are mandatory.

 

 

Statement of Commitment and Understanding for VA Trainees

• sign and date the above form
  
  

Request for Computer Access (VA)

• fill-out, sign and date the Acceptance Of Use Statement

  
  

Declaration for Federal Employment

 

• fill-out, sign and date the above form
  
  

Optional Application for Federal Employment- OF 612

 

• fill-out, sign and date the above form

 

Vehicle Registration Form

• fill-out, sign and date the above form

Department of Veterans Affairs Acceptance Letter/ WOC Letter

 

• WOC Letter will be emailed directly to the student
  
  

VHA Mandatory Training for Trainees  (*1 training module)

Please view the attached PDF file for directions on how to access the combined training module.[PDF}

 

• the information security and privacy training can be accessed at the following link:

https://www.ees-learning.net/librix/loginhtml.asp?v=librix

 

The following items are additional requirements of ALL students completing rotations at the VA:

 

• Copy of current PPD (TB status)

• Copy of Immunization Record

• Fingerprinting

  
  
  

Fingerprinting

Fingerprinting is required of ALL students rotating at the VA.  Be prepared to locate a local VA Hospital in your area.  The Fresno VA will arrange for a “courtesy fingerprinting” to be done.   Fingerprinting must be completed before the start of a student’s scheduled rotation.  As a note, this process takes a minimum of 30 days.

In accordance with new guidelines required by VA Human Resource Management Service, students must complete the entire VA packet and return it to the Medical Student Coordinator, Brittany Riojas, at the UCSF Fresno Center. 

VA Checklist (click here)

The completed packet with ALL forms & documents should be MAILED to the following UCSF Fresno contact at least 2 weeks before the start of the scheduled rotation:

 

Brittany Riojas                                                              
UCSF Fresno Center                                                     
Undergraduate Medical Education Dept.
155 North Fresno Street, Suite 251
Fresno, Ca.  93701

Send questions or comments to: briojas@fresno.ucsf.edu

 

Additional VA contact information

 

Neurology Contact      
VACCHCS- Fresno
Neuro/Rehab Service (127)
Attn: Pat McMurry
2615 E. Clinton Avenue
Fresno, CA 93703
Patricia.McMurry@med.va.gov

Dermatology Contact
VACCHCS- Fresno
Dept. 111
2615 E. Clinton Avenue
Fresno, CA 93703