Resident Check-List & Application Review 2017

Resident Check-List & Application Review 2017

The following document must be completed and returned to the VA by Friday, April 28, 2017.

All Incoming Residents and Fellows:

_____ Application for Health Professions Trainees VA Form

2850d

_____ Declaration for Federal Employment, OF 306

On Question 17, please sign your name on both 17a and 17b as an applicant and appointee

_____ VA Appointment Letter 2017

_____ Mandatory Training for Trainees Certificate of Completion

_____ VA Fingerprinting Information Form

_____ CPRS Computer Training Certificate of Completion

_____ VA Pharmacy Provider Form

For Non-United States Citizens ONLY:

_____ Tuberculin (TB) Skin Test or other negative TB

Documentation (i.e. chest x-ray report)

(The report must have been within the past 12 months)

_____ Proof of non-citizenship or naturalization

Please do not staple these documents. We strongly recommend you make a copy of your completed documents and bring them with you to your VA Orientation.

If you are a fellow and will be working at the VA in another capacity (moonlighting, Emergency Department coverage, etc.) you will still need to complete this entire application.

NO DOUBLE-SIDED PAGES PLEASE