Get Va Cheyenne Vamc Health Professional Trainee Demographic Form_dsa

Completing the VA Cheyenne VAMC Health Professional Trainee Demographic Form_DSA online is a straightforward process. This guide will provide you with comprehensive, step-by-step instructions to ensure all required sections and fields are filled accurately.

Follow the steps to fill out the form accurately.

1. To obtain the form, press the ‘Get Form’ button to access the document in your web browser.
2. Review the form's general information. Begin by selecting whether you will be a Without Compensation Trainee or a Paid Student/Resident/Intern.
3. In the PROGRAM INFORMATION section, provide details such as the name of your institution, your program of study, the degree level you are pursuing, and your anticipated graduation date.
4. Fill in the contact information for your clinical program coordinator or instructors, including their name, telephone number, and email address.
5. Indicate your requested clinical rotation dates by filling in the start and end dates.
6. In the STUDENT/TRAINEE INFORMATION section, specify your status by selecting Resident, Intern, or N/A.
7. Enter your legal first name, middle initial (if applicable), and last name in the designated fields.
8. Input your social security number and telephone number, ensuring to follow proper formatting.
9. Select your area of training by choosing from the list provided, which includes various health fields.
10. Provide your email address in the respective field.
11. Complete the section related to the VAMC clinical point of contact by entering their name and department.
12. If you prefer to email the completed form, acknowledge the associated risks and ensure your compliance.
13. Review all the information entered to verify accuracy.
14. Once satisfied, you can save your changes, download a copy for your records, print the document, or share it as required.

Complete your forms online today to ensure timely processing for your clinical rotation.