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Required paperwork for your training

Find forms and information on how to complete required paperwork for your internship, fellowship, or residency program at VA Pittsburgh.

Completing required paperwork

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

Required forms for all trainees

Patient Abuse Forms

SF-61 Appointment Affidavits

Application for Health Professionals

VA Form 0711 - Request for Personal Identity Verification Card

Form I-9 Employment Eligibility Verification

Selective Service Registration

Program specific forms

Send the following to your trainee coordinator

For long-term trainees
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 should complete:

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

Send the following to your trainee coordinator

Send the following to your trainee coordinator

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

Questions?

For general questions about training, contact the main office:

Andrea Krushinski
412-360-6597
andrea.krushinski@va.gov

For questions about required paperwork specific to your training program:
Contact a trainee coordinator