VA Pittsburgh Healthcare System

Required Paperwork for Trainees

Make sure you have a printer available. When you complete the printed forms, keep a copy of your personal information (name, social security number, etc.). To protect your privacy do not send this information electronically.

All paperwork must be returned to your trainee coordinator PRIOR to your rotation. Contact your trainee coordinator to find out how to return paperwork.

Complete, print and sign all appointment paperwork that pertains to your assignment. ALL trainees must complete:

• Patient Abuse Forms
• SF-61 Appointment Affidavits
• Application for Health Professions Trainees
• OF-306 - Declaration for Federal Employment
• VA Form 0711 - Request for Personal Identity Verification Card 
  (Contact your Trainee Coordinator to find out if you are eligible.)
• Form I-9 Employment Eligibility Verification
• Selective Service Registration
• Mandatory Training for Trainees (MTT) modules

Medical/Clinical and Dental Residents and Fellows must also complete:

• VAPHS Pharmacy Card
• Highmark Billing Forms
• Apply for a National Provider Identifier (NPI)
  You will need to provide your NPI number to your VAPHS Trainee Coordinator.
• VAPHS Computer Access
• Respirator Fit Testing - Schedule an Appointment

Dental Residents, Fellows and all Clinical Trainees who will be with the VA for more than 180 days in aggregate and Physician residents who will be here more than 1 year continuously must also complete:

• E-Quip Background Invesigation - See Service line Sponsor for access.

Psychology Interns and Fellows must also complete:

• Current Vitae

VERC OAA Applicants must also provide:

• Copies of all college/university transcripts (unofficial copes accepted)
• Proof of U.S. Citizenship (birth certificate, naturalization papers, etc.)
• Three Letters of Reference addressed to the Program Director of the
  fellowship discussing your suitability for the program.

Non-Clinical (ex: Administrative) Residents and Fellows will complete:

• VAPHS Computer Access
• EES training - print completion certificate(s) and send to appropriate Trainee Coordinator. You are encouraged to maintain a copy of your training certificate(s).
• VA Privacy and Information Security Awareness and Rules of Behavior
• VHA Privacy Policy Training

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