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Citizenship:

  • Must be a US citizen; no dual citizens.
  • If you possess a foreign national ID card or passport, you will be required to relinquish those documents.

Immunizations Required

  • Covid-19 vaccine and booster
  • Current PPD skin test or T-Spot/Quantiferon blood test (within one year)
  • Hepatitis B
  • MMR
  • Varicella
  • CPR certification (must not expire for the duration of year rotation)

Immunizations Records Submit to and Date:

  • Bring shot records on first day of clinic.

Documentation Required

  • Copy of Driver’s License of Government issued ID card
  • Proof of Citizenship (copy of passport or birth certificate, naturalization certificate, or citizenship certificate)
  • FBI and Department of Justice background checks – TWO original hard-copy fingerprint cards. The prints must be done on hard copy cards only. You cannot complete this requirement with the LIVESCAN digital electronic fingerprinting service so this cannot be done at UCPD. Another police station, Sheriff’s office or UPS store may be able to do this for you. Make sure the fingerprint cards are completely filled out and signed by the person who is taking the fingerprints.
    • One location that can do this is the Alameda County Sheriff’s Office located at 15001 Foothill Blvd in San Leandro. Call them ahead of time to make an appointment. Appointment hours are generally Monday-Friday from 8:30 a.m. to 3 p.m. The cost is $20 per card if paying cash; $20 per card plus $1.50 service fee per card if paying by debit or credit card. Make sure you obtain TWO cards.
    • If Clinic Admin has a supply of cards, they can be done at no charge there. When cards are available, Clinic Admin will send out an email to students to make an appointment with Elizabeth Doty or Dr. Yu to take the fingerprints.
  • Form OF 306 Declaration of Federal Employment
  • WRNMMC PSO Prospective Employee Profile Sheet (incomplete and/or illegible documents WILL NOT be accepted)
    • POSITION TITLE: Student
    • WORKSPACE DEPARTMENT AND DIRECTORATE: Optometry
    • EMPLOYMENT CATEGORY: check “Students/interns/observers” ; POC is Dr. Geeta Girdher; POC Phone Number: (301) 295-0213
  • EQIP Security Background Questionnaire (instructions sent via email and the subject line will read “EQIP SECURITY BACKGROUND QUESTIONNAIRE”- please be aware that you may receive an email from an unfamiliar @mail.mil email to complete the questionnaire). After you complete and certify the application via eQIP, answer the following 4 questions as follows:
    1. Do you want to print the Archival copy of your SF86? We suggest the individual saves this information for their records (we do not need the Archival copy of the SF86)
    2. Do you want to print your signature forms? No
    3. Do you want to upload additional documentation? No
    4. Do you want to release/transit to the next agency? Yes
  • Non Disclosure Agreement (Fillable form) – sign, date and provide SSN number. Under Security Debriefing Acknowledgement, sign and date.
  • Updated Resume/CV
  • Certificate of HIPAA training

Documentation Submit to and Date

  • Students will need to mail all documents except the two below to Walter Reed National Military Medical Center, Optometry Clinic (c/o Dr. Geeta Girdher), Building 8, 1st Floor, Room 1713, 8950 Brown Drive, Bethesda, MD 20889-5629, OFFICIAL BUSINESS. Please send them to her THREE months before the start of your rotation.
  • After Dr. Girdher receives your documents, she will deliver them to the security office.
    They will initiate the background check and directly send you an email on how to complete the application online (via e-QIP). The email will come from Ms. Blair and the subject line will read “EQIP SECURITY BACKGROUND QUESTIONNAIRE”. Please check your spam folder for her email as it often ends up there. After you complete and certify the application via e-QIP, answer the following 4 questions as follows:

a) Do you want to print the Archival copy of your SF86? We suggest the individual saves this information for their records (we do not need the
Archival copy of the SF86)
b) Do you want to print your signature forms? No
c) Do you want to upload additional documentation? No
d) Do you want to release/transit to the next agency? Yes

  • Please complete the EQIP Security Background Questionnaire when you receive an email with that subject.
  • Bring in Certificate of HIPAA training on first day of clinic or send in before arrival.

Other Documents

  • Student Externship Guidelines
  • Student Housing Suggestions – the housing list has not been updated recently and Dr. Girdher cannot certify its accuracy.

Absence Policy

  • Students are permitted a maximum of 4 days off per rotation. This includes all absences (illness, residency interview, personal day, NBEO exam date and travel, etc). Any days missed beyond this time are made up on a case-by-case basis by writing cases reports or providing a presentation on a patient case or topic.