Skip to Content

Learn what the PACT Act means for your VA benefits

Nursing Students

Nursing Students to complete forms to onboard at VA Loma Linda Healthcare System

Complete, Print and Sign all of the following:

REVIEW FIRST – Onboarding Checklist (PDF)

Nursing Student WOC Letter (DOC)

VA Security ROB Form (PDF)

I-9, Employment Eligibility Verification (PDF)

VA Form 710 (PDF)

Self-ID Handicap SF2561 (PDF)

Race Form SF181 (PDF)

Educational Data Form (PDF)

New Employee Info for Badge (PDF)

Clinical Trainee Registration Form (PDF)

Applicant Statement of Selective Service Registration Status (Males Only) (PDF)

COVID-19 Vaccination Form (PDF)

Finger Print Form (DOCX)

Complete Mandatory Training and Print Certificates

The online mandatory training modules are expected to take up to 1 hour to complete, but does not have to be finished in one sitting.

Mandatory Training Instructions (PDF)

During self registration you will need to provide this information:
- VA Location Code: LOM (VA Loma Linda Healthcare System)
- VA Point of Contact Email: VHALOMClinicalEducation@va.gov
Read and Complete

CPRS Computer Tutorials Validation Form (DOC)

Guidelines for Interactions between Clinical Faculty and the Pharmaceutical Industry and Health Industry Practices that Create Conflicts of Interest (PDF)

Processing for students can take up to 6 weeks at a minimum.

For more information, please call Tiffany Gratton 909-825-7084 extension 2008, Tiffany.Gratton@va.gov and Ahmed Hariri 909-825-7084.extension 1511, Ahmed.Hariri@va.gov