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Immunizations Required


Immunizations Records Submit to and Date:

  • Submit copy two months prior to start date to:
    • Molly Johnson, OD Attending Optometrist, Clinic Staff Supervisor, Miami VA Medical Center, Eye Clinic, 1201 NW 16th Street, Miami, FL 33125; Tel: 305-575-7000 x 3910;

Documentation Required

  • VA Forms must be completed and submitted at least two month prior to start date. Please submit forms to Dr. Johnson. If you have any questions, please contact Dr. Johnson at of the following 10 items can be found in the VA Miami Student Packet.  Please note the other documents that must be included in your packet.
  1. WOC Student & Physician Packet Checklist
  2. WOC Appointment Request Memo
  3. Fingerprint Request form
  4. I-9 form
  5. Declaration For Federal Employment (OF- 306.pdf)
  6. Application For Health Professions Trainees (vha-10-2850)
  7. Patient Abuse
  8. English Prof Memo
  9. Authorization for release of information (please complete the final page)
  10. TMS-Self Registration Instructions
  11. International Students and Social Security Numbers:
    • Health professions trainees (HPTs) training at VA medical centers receive temporary Federal appointments and personal identity verification credentials. To be properly vetted and eligible to participate in training, non‑US citizen HPTs who are temporarily in the United States must have:
    • A nonimmigrant F-1 or J-1 student classification; or, an I-20 (or DS-2019) certificate of eligibility; AND
    • A US Social Security Number
    • Unfortunately the use of a “pseudo-SSN” is prohibited in certain Federal systems. Your facility may have found work arounds, however use of a pseudo-SSN, or other 9-digit number, will not be permitted after May 1, 2018. Therefore, we are notifying the field in advance of this change in the onboarding process for non-US citizen trainees.

The following 6 items are available in the individually linked PDFs below:

  • US Citizenship (passport, birth certificate, naturalization certificate). MANDATORY. Please let me know if you are a non-citizen.
  • Fingerprinting: Due to a Federal mandate, students must be fingerprinted prior to their arrival at VA Miami. The VA San Francisco has offered to assist in this process. This must be done NO GREATER than six months before the start of your rotation and no later than 8 weeks.
    • Please go to VA Medical Center, Human Resources, Management Service (05), 4150 Clement Street, San Francisco, CA 94121.  The fingerprinting location is building 4, 2A-103.
    • The hours for fingerprinting are Wednesday 9 a.m. to 12 noon and Friday from 1 to 4 p.m. (first-come, first-serve basis).  No appointment necessary.  Please complete the VA Hospital Fingerprint form (everything above the box).  You will also need to provide the SOI and SON codes so please ask the attending doctor for it. Also, be sure to bring two picture IDs such as Driver’s License, Passport, School ID.
    • If you are having difficulties with the fingerprinting process, you may contact Debbie Wong, Program Support Assistant (Security), (415) 221-4810 x24214.
    • Also, be sure to bring two picture IDs such as Driver’s License, Passport, School ID.
  • For travel insurance coverage, please register all out-of-state travel at the UC Trips website to ensure coverage for each covered off-campus activity. You are covered from the time you start your travel to the rotation, through your rotation, and through your return trip.

Documentation Submit to and Date

  • Molly Johnson, OD, Attending Optometrist, Clinic Staff Supervisor Miami VA Medical Center, Eye Clinic, 1201 NW 16th Street, Miami, FL 33125; Tel: 305-575-7000 x 3910;
  • Selective Service Card (register by Age 26)

Absence Policy

  • Students are subject to the Berkeley Optometry Absence policy.