Central Alabama Veterans Health Care System (CAVHCS)

All students (and instructors) wanting to perform a clinical training assignment at the Central Alabama Veterans Health Care System (CAVHCS) must complete the items listed below. Once ALL items are complete, the entire packet of original printed items must be returned to the Pharmacy Service at least four weeks before the scheduled clinical training date.

Getting Started:

Make sure you have a printer available, as some of these forms cannot be saved.

Follow all instructions carefully.

• Complete, print and sign the Application for Residents 10-2850b.
• Complete, print and sign the Declaration of Federal Employment, form OF-306.
• Complete and print VA Clinical Trainee Registration Form - VA Form 10-0410.
• Read, print, and sign the Pharmacy Scope of Practice form. 
• Complete section 1, print, and sign the Request for Personal Identity Verification Card, VA Form 0711. NOTE: The day you come for finger printing and ID badge you must present two forms of identification as listed on page 5 of this form. 
• Complete the VHA mandatory trainings for trainees. Directions for logging in and locating requirements are included in the attachment (see attached Signing up for the VA Employee Education System). Be sure to read/print this first. Log into the following website and complete the mandatory training course (annual requirements) and print the certificate.
  https://www.ees-learning.net/
• Please read, print, then initial and date each page and then sign and date the last page of the National Rules of Behavior (Attached VA Handbook 6500).
• Print the attached Student Health Requirements form and have the appropriate school official and/or student complete and return with package.
• Print the attached Special Agreement Form (SAC).

  Send completed processing packet to the following address:

  Central Alabama Veterans Health Care System

  Addison Ragan, PharmD, BCPS, CGP (119)
  Program Director
  215 Perry Hill Road
  Montgomery, AL 36109-3798,
  (334) 272-4670
  ext. 4341

   NOTE: Incomplete student processing packets will not be processed and you will not be able to start your training.

  Upon receipt of your forms, our Human Resources department will contact you to arrange a time for you to come to the facility for fingerprinting and other entry processing requirements.

  • One government issued photo ID (i.e. driver license, military ID, passport) and one non-photo ID (see list on VA Form 0711, page 5, item 4 above).
  • Permanent Resident Card (if applicable).
  • Vehicle Registration and proof of insurance (if applying for a VA parking permit).