VA Palo Alto Health Care System

Optometry Training Program Director:

Lee Vien, OD, FAAO

Lee.Vien@va.gov

Optometry Administrative Trainee Coordinator:

Vanessa Perez

Vanessa.Perez3@va.gov

650-493-5000 x68340

Immunizations and Document Requirements

Required Immunizations

• Covid-19 Vaccine and booster
  • Must be vaccinated with booster.
  • Complete VA Form 10-263 and submit along with a copy of your Covid-19 vaccine card.
  • If student is not receiving the COVID-19 vaccine, they must file for an exemption (medical or religious) using the VA Form 10-263.
  • If student is not vaccinated or filed an exemption by October 7, 2021, they CANNOT come to the VA.
  • If student is NOT fully vaccinated (and filed an exemption), they may need to complete COVID-19 testing WEEKLY.
  • Please submit a copy of your Covid-19 vaccine card and VA Form 10-263 to the appropriate Optometry Trainee Program Coordinator.
• HBV (Hepatitis B)
• MMR
• Current PPD/TB
• Varicella
• Tdap (Tetanus, Diptheria, Pertussis) – Get either a Td or Tdap booster shot every 10 years after first dose)
• Influenza by November 30th of each year
• All students should have all of their other immunizations up to date as required by UC Berkeley School of Optometry’s training program. Immunization documents should be readily available if they are requested.

Required Documentation

• All students should review this website for requirements.
• Read the entire website carefully, follow each instruction, and send the completed list of requirements to your Trainee Coordinator

LIST OF REQUIRED DOCUMENTS

1. Students’ Requirements Checklist
2. Fingerprint form
3. Form – OF 306
4. Training Certificate – TMS Mandatory Training for Trainees
5. Two Valid IDs (Names must match)
6. Form – VAF 10-2850d
7. Proof of COVID Vaccination or obtain an exemption for medical or religious reasons- email to Trainee Coordinator

ADDITIONAL REQUIREMENTS

7. Fingerprint Appointment: Due to a Federal mandate, students must be fingerprinted prior to their arrival at a VA Palo Alo Health Care System site.

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:

• This must be done NO GREATER than 120 days before the start of your rotation and NO LATER than 8 weeks before the start of your rotation.:
  • Palo Alto VA Fingerprints
  • SOI# VA F1
  • SON# 1440
  • Organization: VHA
  • Employee type: Student/Trainee or Affiliate (if Student/Trainee option is not available)
• Inform your Trainee Coordinator of your fingerprint date and location

8. Badge Pick-up Appointment

• The Optometry Administrative Trainee Coordinator will contact you regarding the badge appointment.
• You must bring two valid IDs with you your appointment.

9. Clinic attire: clinic jacket; scrubs are okay (preferably blue)

10. The VA will continue to supply PPE for the students but they may have to purchase their own eye protection.

SEND ALL REQUIRMENTS TO YOUR TRAINEE COORDINATOR CONTACT BELOW NO LATER THAN TWO MONTHS PRIOR TO YOUR START DATE. You may e-mail, fax, or send via postal mail.

Attn: Vanessa Perez

E-mail 

Vanessa.Perez3@va.gov

or

Mail

Vanessa Perez

Administrative Officer

VA Palo Alto Healthcare System

3801 Miranda Ave. 112/Optometry

Palo Alto CA, 94304

Phone (650) 493-5000 ext 68340

or

Fax

650-849-0319

(if sending documents via fax, please call Vanessa Perez to confirm receipt at (650) 493-5000 ext 68340)

Absence Policy

• Any leave must be requested at least 1 month in advance of the desired day off and be pre-approved by the Optometry Trainee Program Coordinator.  Requested leave will be granted only at the discretion of the Optometry Trainee Program Coordinator.
• Granted days off may require an assignment: PPT presentation (in addition to the presentation required for all trainees), summary of an assigned journal article, or an AAO style case report as noted below.  The type of assignment will be determined by the Optometry Trainee Program Coordinator.
• Boards: no additional assignment

1. NBEO Parts I and 2: NBEO Parts I and 2: travel days are not approved for UCBSO students as these tests are offered locally.
2. NBEO Part 3: Travel days are allowed 1 day prior to and 1 day after the date of the Part 3 examination unless the test date falls on a Monday or Friday.  In which case there is no travel day allowed prior to the test if the test falls on a Monday and there is no travel day allowed after the test if the test falls on a Friday.
3. Law test: the student is requested to schedule their test in the morning so that he/she can return to clinic in the afternoon after taking his/her law test

• • Religious holiday: no additional assignment
  • AAO, ARVO, SECO: 1 additional assignment for the entire meeting; any other meeting will be a case-by-case decision of the Program Coordinator
  • Residency interviews: 1 additional assignment for each day taken off; the maximum number of days off that can be granted is 5 days
  • Approved personal leave or non-COVID sick leave, additional assignments for each day taken off. Approved personal leave will be considered on a case-by-case basis and include but not limited to personal wedding, funeral, and does not apply for study days for board exams. COVID related leave will follow VAPAHCS occupational health guidance and additional assignments may be assigned.
  • Death in immediate family or personal childbirth: no additional assignment
• Optometry trainees who are achieving a passing grade, but miss ≥ 10% of their assigned clinic days, will receive an “incomplete”.  Optometry trainees who miss ≥ 10% of their assigned clinic days and are achieving a failing grade will still receive the failing grade.

Grievance

All Optometry Trainee Program Coordinators maintain an open-door policy.  If you have any concerns, please talk to your Program Coordinator immediately.  If you feel uncomfortable talking with your Optometry Trainee Program Coordinator, you can discuss matters with the Optometry Training Program Director.