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Alameda Health Systems (AHS):
Eastmont Wellness Center (EASTMONT) in Oakland, CA and
Hayward Wellness Center (HAYWARD) in Hayward, CA.

AHS Absence Policy

  • Please note that the absence policy for AHS Eastmont Wellness Center and AHS Hayward Wellness Clinic requires that students submit absence requests via Meditrek at least SIX WEEKS (42 DAYS) in advance of the desired absent date. Absence requests submitted within six weeks of the desired absence date will be denied. This is due to Alameda Health Systems’ internal patient scheduling policy.
  • In order to ensure that students are attending their Alameda Health externship for 90% of the operating dates, students will be reassigned to Minor Clinic when an instructor is absent and no substitute can be found.

Class of 2023 Student Onboarding Schedules

  • Attending AHS in Summer 2023 – Please complete and submit your requirements between March 1 and April 26, 2023.
  • Attending AHS in All Other Sessions – Please complete and submit your requirements between three months and no later than four weeks BEFORE the start of your rotation.

Submittal Instructions

Once you have completed ALL requirements and your document package is complete, please email them to Liz Doty at and Dr. Vikki Yu at vyu@berkeley.edu in ONE PDF with the subject line as: AHS 2022 or 2023 Forms for (Name). Please DO NOT email any documents in separate emails or before they are all complete. See below for further submittal instructions.

The documents should be ordered in ONE PDF in this order:

  • ID Badge Form (signed second page only – please indicate date as one month before start of rotation).
  • AHS Covid Attestation.
  • AHS orientation handbook acknowledgement form only (signed, please indicate date as one month before start of rotation).
    Supervisor Name: George Lee, OD.
    Phone: (510) 642-9677.
    Department Where You Will Work: Optometry.
    For Campus, circle either ‘Hayward Wellness Clinic” or “Eastmont Wellness Center.”
  • AHS Student confidentiality and security agreement only (signed, please indicate date as one month before start of rotation).
  • AHS privacy and confidentiality handbook form only (signed, please indicate date as one month before start of rotation).
  • Cleared criminal background check letter (ONLY the one page background check clearance/results letter. DO NOT include the three Livescan forms that you FAX to UCPD)/
  • Immunization documents (see specifics below in immunization section, G).

Credentialing

In order to see patients at Alameda Health Systems AHS (Eastmont Wellness Center and Hayward Wellness Center), you must have a photo ID Badge issued by AHS. These requirements are for all AHS locations. See below for requirements for credentialing.

  • If you do not have your badge by the first day of your AHS rotation and are unable to see patients, you will accrue three (3) debit days for each day that you miss clinic.
  • Class of 2023 – All AHS ID Badges will need to be turned into Clinic Admin during Old Home Week in May 2023 and will be returned to AHS.
  • Please note that all fees for training/checks/testing that are associated with the clearance process will be at student expense. Once you have completed the clearance and received your ID badge, it is valid for Eastmont and Hayward locations. Therefore if you are attending any of these clinics but during different sessions, you only need to go through the clearance process once. Additionally, once you have your ID badge, you may substitute for other clinicians at Eastmont or Hayward on an as-needed basis for clinic credit.
  • Please note that even though AHS clinic need immunization records for onboarding, the office of record for your immunizations in the Admissions and Student Affairs Office (ASAO). Please make sure they also receive a copy of any new immunization documents you obtain.
  • When you have completed your clearance and have obtained your ID badge, please notify all of the following:
    Liz Doty: elizabeth.doty@berkeley.edu,
    George Lee: gkl@berkeley.edu and
    Vikki Yu: vyu@berkeley.edu.

Steps for Credentialing

Step 1: Student Completes ALL of the following requirements:

Please provide all documents as evidence of the requirements and submit them as ONE packet to Clinic Administration.

A. ID Badge Form
Sign and only include second page – Liz Doty and Dr. Yu will complete the rest.
Download here.

B. AHS Covid Attestation
Review the Safety Policy here and complete and sign the Covid Attestation.

C. AHS Orientation Booklet Signature Acknowledgement
Please see the AHS Orientation Handbook: sign the Acknowledgment Form on Page 63 and include only this page with packet of documents. (AHS may also ask you to complete this form at the beginning of your rotation.)

D. AHS Privacy and Confidentiality (Student Confidentiality and Security Agreement)
Sign form and include only this page with packet of documents.
Download here.

E. AHS Privacy and Confidentiality Handbook
After reading AHS Privacy and Confidentiality handbook (AHS-HIPAA Handbook), sign the Confidentiality and Security Agreement form on page 20 and include only this page with packets of documents.
Download here.

F. Cleared Criminal Background Check.
Fingerprinting can only be done in the state of California via the digital fingerprinting Live Scan process.

  • You will need to complete the fingerprinting for a background check done via a Live Scan process if you are in the state of California. This requirement will check the FBI and California Department of Justice (DOJ) databases (in addition to obtaining the following information: Sex Offender Registry, OIG/GSA, SSN Address Locator and County Criminal databases).
  • It is recommended to do the fingerprinting during the session or two immediately prior to the session when you attend AHS. However, if you are on out-of-state externships for two sessions before your AHS session, please do the fingerprinting between one to two weeks before you leave the state of California. Allow a one-week window before you leave the area to be able to complete re-prints at if needed.
  • If you are attending BOPC, Travis Air Force Base AND Alameda Health Systems (and the rotations are within six months of each other), please follow the fingerprinting instructions under Alameda Health Systems requirements. Background check results will be kept on file in Clinic Admin, but must be completed and on file SIX to EIGHT weeks before the start of your either your BOPC, Travis AFB or AHS rotation. The background check must be completed by the earlier of the three deadlines for AHS, Travis AFB or BOPC.) Please note that a background check done on mybackgroundcheck.com (acceptable for BOPC or Travis AFB) WILL NOT be acceptable for Alameda Health Systems (must be done via Livescan).
  • If you are attending Over 60s and Alameda Health Systems (and the rotations are within six months of each other), please follow the fingerprinting instructions under Alameda Health Systems requirements. Over 60s will accept a background check if done within a year of when you start. However, AHS will accept background checks done within 6 months so please consider the timing of when to get your background check. Background check results will be kept on file in Clinic Admin, but must be completed and on file SIX to EIGHT weeks before the start of your either your Over 60s or AHS rotation. Please note that a background check done on mybackgroundcheck.com (acceptable for BOPC, Over 60s or Travis AFB) WILL NOT be acceptable for Alameda Health Systems (must be done via Livescan).

Fingerprinting Protocol (effective July 2, 2022):
Below are the steps and what you need to know to schedule your fingerprinting appointment with UC Berkeley’s fingerprint service provider, Biometrics4ALL, Inc. You will be able to have fingerprints done anywhere in the United States. When making your appointment, be sure to have your credit card available for the applicable fees. The scheduling website works best with the Google Chrome browser. See the table below for further instructions.

Step 1Use the School of Optometry fingerprinting link to schedule your appointment.
Step 2Enter all your personal information, following the prompts. Important: You must use the legal name that matches the name on your government ID when scheduling your appointment
Step 3 for CALIFORNIA Locations if you are doing the fingerprinting while in CaliforniaWhen in the state of California, you will be doing digital LIVESCAN for fingerprinting.Review all fingerprinting locations and make your appointment at a location that is most convenient for you and works best based on availability.
Step 3 for NON-CALIFORNIA Locations if you are doing the fingerprinting outside of the state of California

If this applies, you will complete two (2) “hard cards” for your fingerprints with ink instead of having them submitted electronically.



These instructions are also outlined on the scheduling website as you make your appointment.
When you are out of the state of California, you cannot do LIVESCAN fingerprinting. Instead, you must obtain and submit two hard-copy fingerprint cards done with ink.
  • Follow steps 1-2 as shown above.

  • Continue with the transaction by choosing Ink Fingerprint Processing Center.

  • Find the location in your city/state that is most convenient. The local Police Department Sheriff's Office, or UPS store may be an option or you can choose another location.

  • It is recommended that you call the location to ensure their fingerprinting services also include offering hard card processing.

  • You will need to pay fingerprinting fees (see fee structure below) using your credit card.

  • After choosing the location and paying the fee with your credit card, print out the Request Form (you will see this after the purchase/fee).


    • After attending your appointment: write the “Payment ID” on the top of both hard cards. This will be reflected on a confirmation email you will receive. It should also be reflected on the Request Form you are asked to print prior to your appointment.

    • Mail the Request Form along with BOTH completed fingerprint cards (a.k.a FD-258 cards) via a trackable service such as USPS Express Mail, UPS or FedEx to:

      Capital Live Scan
      ATTN: AS.com Ink Card Processing Center
      5706 Broadway, Sacramento, CA 95820


    Important: Be sure you DO NOT FOLD the hard cards across any fingerprints as it will interfere with processing. Your fingerprints will be submitted within 24 hours of receipt of the COMPLETE mail-in package.
    Step 4Please complete ALL of the following three forms for your fingerprinting done at UCPD. If you do not provide UCPD with the forms, they will not know who to send the background check results to. Fax all forms as soon as you have completed your appointment ad fax to UCPD at (510) 643-4655.

    1. Request for Live Scan Service. Print one copy and complete section 3 - see sample (Request for Live Scan Service SAMPLE). The ORI number is CA0019700 which goes on the top left of the form. Be sure to make/ask for a copy of the form once it has been processed by the agent (the agent may write down some transaction numbers). Even a photograph of the form is acceptable. In the case that you have to re-do the fingerprints, the agency may need to refer to the original LiveScan form.
    2. Release and Disclosure Form (The witness can be anyone in Clinic Administration, UCPD, or if the former are not possible, anyone.)
    3. Job Description for Optometric Interns.

    G. Immunizations

    Proof of Covid-19 vaccines and booster.

    • Current 2-Step PPD skin test (TST) or IGRA –blood test (QFT or T-Spot). Test must be done within 12 months of obtaining clearance and not to expire during your rotation. Date of last 2-Step PPD test administered, must show annual TB surveillance with no lapse in time. If known positive, must show chest x-ray (within past 4 years, must also include documentation of positive TST history and a current TB Symptom Survey).
    • 2-Step PPD Test: The two-step test is NOT the usual PPD skin test in which you receive an injection of PPD and the test area is observed one time at specific time frame. The two-step PPD test is used to detect individuals with past TB infection who now have diminished skin test reactivity or to offset potential false negative testing results. This procedure reduces the likelihood that a boosted reaction is later interpreted as a new infection. Step 1 is a TB test done within the last year. The second TB skin test must be completed at least one week after the first TB skin test. Step 2 is a negative TB test done within the last three months. If the second test is negative, the person is considered uninfected. If the second test is positive, then the person is considered to have a “boosted” reaction to an infection that occurred within 12 months.
    • For those whose last TB test is over one year ago, please follow this 2-Step PPD Test. In this procedure a person is given a baseline PPD test. If the test is negative, a second test is administered one to three weeks later. If the second test is negative, the person is considered uninfected. This two-step PPD will require four visits.

    Proof of TWO (2) vaccines, and or positive titers.
    Proof of Hepatitis B vaccine series, positive titer or declination.
    If you have not done within ten years, you may need a T-Dap vaccination or you can opt out by completing a declination form, linked below. If you wish to opt out, please complete the form and include with your documents.
    During Flu season, must show proof of flu vaccine. Flu vaccine should be received between October 1st and March 31st, but preferably around October 1st. Please include documentation if you are going to AHS during Fall 1, Fall 2, Spring 1 and Spring 2 rotations.

    • You may want to obtain your immunization records from ASAO. If you are missing any immunizations, please see your primary care provider, the Tang Center or have the immunizations done at AHS.
    • Please see AHS Immunization Health Screening Requirement and Price Sheet. This form provides the fee schedule for immunizations in the event that student or instructor would like to have services administered at Alameda Health System.
    • At AHS, please be sure to arrive 15-20 minutes earlier than your appointment. You will need to go to the E Building at Fairmont Campus and pay prior to your immunization procedures. They accept Credit Card, Checks and Cash.

    Forms
    T-Dap Declination Form.
    AHS Immunization Health Screening Requirement and Price Sheet.
    COVID-19 Declination Form and Medical Exemption.
    COVID-19 Declination Form and Religious Exception.

    H. Learning Goals and Objectives

    Step 2: Submit Documents to Clinic Admin

    Please submit all your documents in one complete packet to Clinic Admin for review. You may leave them in an in-box “AHS Forms – 3rd years) at the Clinic Admin front desk. If there are any issues (missing documents), they will contact you. Once the documents have been approved, Clinic Admin will provide each student with two signed forms after receiving ALL required documents listed above:

        • Clinical Experience Requirements form
        • ID Badge Form

    Step 3: Provide Signed Forms to AHS

    Provide signed forms to the Alameda Health System Highland Campus Human Resources front desk to obtain photo ID Badge.

    • A State Issued ID, Passport or School ID.
    • Provide both completed signed forms: Clinical Experience Requirement form (signed by Dr. George Lee) and ID Badge Form (signed by Dr. George Lee).

    If you have any questions about the process and requirements, you may contact Dr. Yu or Jaya Iyer, HR Service Representative, (510) 346-7543, jaiyer@alamedahealthsystem.org.

    Step 4: ID Badge Receipt Notification

    Once you have received your ID badge, please send an email notification to Dr. George Lee , Elizabeth Doty at and Dr. Vikki Yu at vyu@berkeley.edu.

    Step 5: ID Badge Return

    All AHS ID Badges will need to be turned into Clinic Admin during Old Home Week in May 2023 (Class of 2023) or May 2024 (Class of 2024) and will be returned to AHS.

    Step 6: EMR Access for AHS

    As the start date of your rotation nears, you will receive an email from Dr. George Lee so that he can help you establish EMR access for AHS.