Durham VA Health Care System
Associated Health Trainee Checklist: Psychology, Chaplain, and Pharmacy Service (Non-Physician) WOCCongratulations on your new appointment as an associated health trainee at the Durham VA Health Care System. We are excited to have you on the team. We hope your time with us is both exciting and motivating. Below you will find links to the paperwork required for Duke Residents. Complete, print out, sign and turn in all paperwork together to Program POC. Again, congratulations and welcome to the team.
POC: Jonathan King, Academic Affiliations Coordinator, 919-286-0411ext 175252
(Please download each document to your computer in order to edit and input your information.)
Welcome Letter - For your records
Training Qualifications and Credentials Verification Letter (TQCVL) - TQCVL must be updated annually or for each training cycle by the affiliate. Submit to Education Service. TQCVL must be signed by VA Leadership prior to rotation. Education must have the TQCVL at least 30 DAYS before the actual rotation date. A copy at Service level
Appointment Letter - Review, sign and return to DVAHCS Service POC. Please submit this document to HRMS.
VA Form 10-2850d Application for Health Professions Trainee, Dated Nov 2011 - Provide (FIRST, FULL MIDDLE NAME, LAST) name. If you don’t have a middle name, indicate “No Middle Name”. If you have only initials in your name, provide them and indicate “Initial only”. Please provide your complete name & SSN at top of Pages 2-4. Sign pages 3 & 4. Turn in to DVAHCS Service POC.
Form (OF) 306 Declaration for Federal Employment, Revised October 2011 - Provide (FIRST, FULL MIDDLE NAME, LAST) name. If you don’t have a middle name, indicate “No Middle Name”. If you have only initials in your name, provide them and indicate “Initial only”. Sign page 3. Turn in to Service POC.
Determination & Certification of English Language Proficiency - Fill in your information. Turn in to DVAHCS Service POC. Submit to HRMS.
Standard Form 61 Appointment Affidavits Revised August 2002 DO NOT SIGN: Until you are instructed to sign while in the presence of a VA Official. Fill in your information. Turn in to DVAHCS Service POC. Submit to HRMS.
Random Drug Testing Notification and Acknowledgement - Review, sign at bottom and return to DVAHCS Service POC. Submit to HRMS.
VHA Mandatory Training for Trainees (MTT): must be completed prior to submitting paperwork on April 12, 2019
Go to TMS website-Self register and complete MTT. You need the following information to complete self-registration
VA Location: DUR
DVAMC POC: ___________________
DVAMC POC email: _________________
DVAMC POC telephone #: ______
Please provide your POC a copy of your course completion certificate. The POC must verify your TMS account and training status before processing for network access and/or PIV badge.
Fingerprint Prep Sheet - Complete all boxes and turn in to DVAHCs Service POC. You will need a copy of this document when you go to get you PIV.
Courtesy Fingerprinting If you have a nearby VA, you can begin the fingerprint clearance process prior to arriving in Durham.
Present the DVAMC Appointment letter and the Courtesy fingerprints document to your Local VA Facility. Locations for courtesy fingerprints can be found at: http://www.va.gov/pivproject/piv_badge_offices.asp . Advise POC when courtesy prints were taken
The POC must provide courtesy fingerprint request memo to the WOC.
NON-US Citizen Request Memo (If applicable) Only to be completed by non-US Citizens. Fill in highlighted blocks through item 3 and turn in to DVAMC service POC. Include a copy of your VISA.
Lost, Stolen, Destroyed, or Damaged PIV Badge - If previously issued a PIV badge that has been lost, stolen, or destroyed, please fill out the PIV Memo and send to POC.
Personal Identity Verification (PIV) - Submit copy of social security card, and Driver’s License, State ID, or passport to your POC. Notify POC of any changes prior to orientation.
Current PIV badge holders - If you presently have a PIV badge from another VA facility, please advise your POC. POC must ensure badge and sponsorship meets station requirements.
Identification - Bring two ID’s from the List of Acceptable Forms of ID to orientation appointment
VA TRAINEE SATISFACTION SURVEY - Please take a few minutes to complete the 2019/2020 VA Trainee Satisfaction Survey. Optimized and shortened for mobile and smart devices.