OMB Control No. 29000205 Estimated Burden: 30 Minutes Expiration Date: 05/31/2026HEALTH PROFESSIONS TRAINEE DATA COLLECTION FORM SEE LAST PAGE FOR PAPERWORK REDUCTION ACT, PRIVACY ACT, AND INFORMATION.

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How to fill out the VA 10-2850D online

The VA 10-2850D form is an essential document for individuals looking to apply for clinical training programs within the Department of Veterans Affairs. This guide provides clear instructions on how to navigate and complete the form successfully online.

Follow the steps to fill out the VA 10-2850D form efficiently.

  1. Click ‘Get Form’ button to obtain the VA 10-2850D form and open it in the online editor.
  2. Begin by completing Section I: Applicant Information. Fill in your full name, any other names you may have used, your present address, phone numbers, email addresses, social security number, date of birth, VA training facility, and your training dates.
  3. Proceed to Section II: U.S. Military Duty Status. Indicate your military status by answering questions regarding your current involvement in the U.S. military and the reserves or national guard.
  4. Move on to Section III: Citizenship. Specify your citizenship status, place of birth, and any information regarding non-U.S. citizenship if applicable.
  5. In Section IV, provide the necessary information for the designated education officer to complete regarding the trainee qualifications.
  6. Complete Section V and VI regarding your current and previous licenses, certifications, or registrations in your clinical profession.
  7. Fill out Section VII: Education and Training post-high school, detailing your institution, program dates, and awarded degrees.
  8. In Section VIII, if applicable, provide details about your graduation from an international medical school.
  9. Fill out Section IX regarding your internship, residency, and fellowship training, including relevant institution names and dates.
  10. Section X requires answers to additional questions regarding your qualifications and professional conduct.
  11. If needed, provide further explanations in Section XI: Remarks, referencing the applicable item numbers.
  12. Finally, certify your application in Section XII by signing and dating the form to confirm that all information is accurate, and submit the completed form.

Complete the VA 10-2850D form online to ensure your application for clinical training is processed efficiently.

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