VA Kernersville Health Care Center (Kernersville, NC) – VA KERNERSVILLE

Immunizations Required:

• TB Test (blood test or single negative skin (PPD) test acceptable
• Hepatitis B series or have signed declination waivers
• Influenza vaccine by November 30th or an exemption for medical or religious reason, (trainees are aware of the requirement to wear a face mask throughout the influenza season while at the VA healthcare facility when an exemption to the influenza vaccine has been granted).
• MMR
• Varicella
• Tdap (Tetanus, Diptheria, Pertussis) – Get either a Td or Tdap booster shot every 10 years after first dose)
• Covid-19 Vaccine and booster card




Immunizations Records Submit to and Date:



Send immunization records to Dr. Timothy Shoff at Timothy.Shoff@va.gov at least one month before start date.

Documentation Required:

You will be rotating at the Salisbury VAMC Health Care System – Kernersville Health Care Center Eye Clinic.  Here is the beginning of your processing into the Salisbury VAMC Health Care System.

PART A: Digital Fingerprints

1. 1. Due to a Federal mandate, digital fingerprints are required for onboarding at the VA Kernersville.
   2. Fingerprinting must be done at a VA and is provided as a courtesy service.
   3. You can be fingerprinted locally at VA San Francisco or VA Martinez.
      • You can get fingerprinted at the San Francisco VA on a walk-in basis:

1. • Please provide the following numbers for the fingerprint process.  “SOI-VAB2” and “SON-1289”.  Please bring this fingerprint request form already completed to expedite things for you when arrive.
   • If you have ANY problems, just let Dr. Loo know and she will have their people run some interference for you.
   • While this is listed first, fingerprints do not have to be completed until THREE WEEKS and NO EARLIER THAN 90 days before you arrive. Some VA’s only do courtesy fingerprints on certain days.

PART B: Form 0711 simplified and HPT Self Enrollment Instructions (TMS MTT) – These are the first and most key documents.  When you get them back to me, I will send you another, larger packet of paperwork on which you can take your time to complete.

1. Please have the completed 0711 Form and HPT/TMS MTT completed with the 3 MTT certificate(s) (documents – may be scanned together) emailed or faxed to Dr. Loo by MIDNIGHT 2 months before your start date.
2. 0711 Form:  Spell out all the words, please do not use abbreviations for eye/hair color (“B” is blue, brown, black, blonde…).
3. TMS MTT certificate:  NOTE: This system has just been updated so there may be some changes they forgot to tell us about so 1) do not become frustrated if it doesn’t work, just follow any given contact links or email Dr. Loo and 2) don’t wait until the very last minute or you might be stuck without having help. Also note that it is best if you use a PC rather than a Mac for this but if you do use a Mac, you must use either Firefox or Internet Explorer 8.0 or higher or you are going to have problems.
4. Here is the link for HPT/TMS MTT Self Enrollment:  https://www.va.gov/oaa/mandatory.asp
   • Please read the directions on the page to select between First Time Users versus Refresher.  Most of you will be first time users but if you have been at another VA it will be a refresher and you should already have an account.  If your time at another VA is recent enough, you may not even need the refresher course and would just need to send the copies of the certificates that are current (please contact me if this is the case just so we set you on the right path for processing).  The instructions are pretty straightforward but the area you might need some guidance is where it asks about “Job Information”:
     • VA Location:  Search “SBY” and W.G. Hefner VAMC should come up for you to select (everyone is part of the Salisbury System, regardless of where your assigned location of Charlotte, Kernersville or Salisbury Eye Clinics
     • Trainee Type:  Associated Health
     • Specialty/Discipline:  Optometry
     • VA Point of Contact first name:  Tiffany
     • VA Point of Contact last name: Ferguson (it says Grant but she has since changed her name)
     • VA Point of Contact email: Tiffany.Ferguson1@va.gov
     • VA Point of Contact phone number: 704-638-9000 ext. 4929
     • Medical Sharing Type: Leave blank, do not need to complete
     • School/University Program:  Your Optometry School
     • Start date:  Date you started Optometry School
     • Estimated Completion Date:  Date you will be graduating Optometry School
5. When you finish, there will be an MTT certificate (every once in a while there are more than one; this is fine, it works either way but if you are issued more than one, we’ll need copies of all of them).  You can either screen capture the certificate (not just the portion that says you’re done – it must be a certificate with your name and the date on it) and email it alone, print and scan it with or without the 0711 form and email (Kristine.Loo2@va.gov) or fax them to (336)515-5308.  By the way, you must attach the scanned document(s) to the email; you are not able to embed Google drive or any other storage drive links into the email since those are not allowed by the VA email security system.  Also, please try to save them as pdf files and not jpg files since pdfs tend to be a lot smaller.  Please scan them all together in one pdf.
6. Print out the New Optometry Student Checklist and use it to make sure you’ve sent in everything.
   Please print out and complete the following:
   • Do’s & Don’ts – PIV & Non-PIV
   • Optional Form 306 – Declaration of Federal Employment
   • Optometry Paperwork – Initial Associated Health Trainees Application Package Checklist (Word Document)
   • Standard Form 61 (SF61) – Appointment Affidavits
   • VA Form 10-2850D – Application for Health Professions Trainees
7. If there is an item or items you can’t figure out or has to wait for some reason, let Dr. Loo know. She can get it sorted out either by email or once you arrive. There are just a few forms that have old dates. Simply cross it out and write the correct one above it; it is the form that important to them, not the imbedded dates.
8. Anything that needs to be notarized can be sent in filled out without the notarization if you can’t find one, our Administrative Officer is a notary and she will be happy to help you if and when she is able to carve time out of her schedule, so do try to find one.

Documentation Submit to and Date

• Requirements are due TWO MONTHS before your start date. Please scan them as one pdf and email them to Dr. Kristine Loo at kristine.loo2@va.gov or fax them to (336)515-5308.
• Please note that one of these forms you’ll be signing says you can’t use Google Drive or similar drop box type file sharing sites for internet security reasons so be sure you do not try to send the forms back through one of them. Also, there are size limits for VA email as a security measure so if you can batch forms into a PDF smaller than 10M, that is best.

Absence Policy

• We are affiliated with nine different optometry programs each having different leave suggestions. However, all of them defer to us for the final leave policy. Therefore, the following are the policies for the Salisbury VA Health Care System.
• All requests, both planned and unplanned (e.g. sick leave), MUST be done through the Externship Coordinator (Dr. Timothy Shoff) so that coverage can be obtained if possible.  Appropriate contact information will be given.  For sick leave, the ONLY acceptable forms of contact are text with response or a phone discussion (email and voice mail without a response are not acceptable as any possible coverage could be severely delayed).
• For each month that you rotate with us, you are allotted one day off where no makeup is required. Therefore if your rotation is for two months, you are allotted two days off; three months, three days, etc. (we do not round up but we will give half days as those are useful for appointments so if your rotation is 2.5 months, you have 2.5 days, not three).  This is to include personal AND sick days so make sure you do not use them all at once and then have need for a makeup.  However, if needed you may use the days together or all in one month if you wish, you do not need to space them to one each month; that is simply the guide we use to grant them.  Also, you are under no obligation to use any days off (many students do not) and we would hope they would only be utilized for needed situations.  The clinical cases you miss by taking time off during your fourth year might be those most valuable to your future as a clinician.  NOTE:  Special considerations do occur.  For instance, if you are on a six-month rotation, your break days between the two quarters that make up the six months are not considered automatically off, but you certainly may request them as off.  Just be certain to do that in a timely manner and not wait until the last minute (one month is required for non-urgent requests – see below).
• It is our policy to have only one student off on an individual day so it is to your advantage to ask early and you should request your days off as soon as you know them but no later than one month prior to the day you are requesting.  Please request them professionally as you would if you were asking an employer (e.g. do not present the date as a “done deal” regardless of its urgency to you; request the date with understanding that because of policies and clinical needs, it may not be able to be granted).
• Makeups are somewhat difficult at the VA since we have Saturday clinics only in rare situations. If they are available, you can be assigned to those but otherwise makeups will need to either involve your travel time between rotations, or since many programs do not have those, a American Academy of Optometry style paper (http://member.aaopt.org/becoming/reportguide/#sample) will be required for each make up day.  Other alternatives may also be available.
• First/Last Day:  Because your Orientation and Clearance Days have been planned for months in advance, we are unable to allow you to take off either the FIRST or LAST day of your rotation except for extenuating circumstances.
• Fridays:  Because of the “one extern off per day” policy and the number of students rotating at any one time, you will initially be limited to requesting only ONE Friday.  If other Fridays are available, they can certainly be considered on a case by case basis.
• NBEO Part 2:  This exam typically falls the Tuesday or Thursday after Thanksgiving or that following week.  The day after Thanksgiving is a workday at the VA.  Because days around this time are popular to request, you will be allowed to choose the day after Thanksgiving OR the day before Part 2 off (whether you take the Tuesday or Thursday offering) or, because these days would count toward your allotted time, you may select neither and use that at another time (such as residency interview travel dates).  If most select the same day, there may have to be a lottery. The day of Part 2 is, of course, allowed off without counting toward your allotment of days off.  If you are retaking either Part 1 or Part 2, you will need to use your allotted days.
• NBEO Part 3:  It certainly makes sense for you to take Part 3 while you are here and we have no problem with this; however, please do not schedule your exam the first week you are here as you will still be orienting to the computer system most of that week.  Do try to schedule your exam on a Wednesday if at all possible.  Alternative days are Thursday, then Tuesday.  Please try to avoid Monday and Friday.  You will be allowed the entire day off for Part 3 which will not count as one of your days off.  If you must repeat all or a portion of the exam during the same rotation, you will be expected to use days from your allotted time off.
• National/Local Optometric Meetings:  We do wish to encourage students to participate in Local and National Meetings to encourage life-long learning and networking.  Academic meetings may be considered outside your allotted days off but on a case by case basis and proof of attendance is required.  Only one meeting per rotation is covered in this manner, subsequent meetings could be attended using allotted time off requests.
• Residency interviews:  Having seven residency positions ourselves, we are very much aware that you would wish to have a physical interview with your potential match site. Therefore, residency interview DATES will be excused up to a reasonable number of interviews.  Travel days would come from your allotted time off as most students are able to obtain travel to their site the night before and return the evening after.  Half days are allowed to maximize your travel time.  Travel to extreme locations may be considered on a case by case basis.  Confirmation of your interview (either copy of letter or forwarded email) is required.