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VA North Texas Health Care System

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Instructions to Complete Application Process for Resident or Fellow

Welcome to VA North Texas Health Care System; one of the largest VA Healthcare Systems in the nation. We have over 100 education affiliations with a wide variety of specialties.

In order to facilitate in-processing at the VA North Texas Health Care System, we request that you complete the required paperwork and mandatory training prior to your arrival for rotation at VANTHCS. Before you begin, be sure you have a printer available, as some of these forms cannot be saved. Please follow the instructions below and when you complete the VA printed forms, bring two (2) copies of all items requested below to your VANTHCS service education program coordinator prior to coming to Human Resources Department to be fingerprinted. To protect your privacy do not send this information electronically.

Special Attention!

1.  Starting Academic Year 2011-2012, resident will be issued a NON-PIV ID Card and a background investigation will be required. If you will be starting your rotation between July 1, 2011 and Sept 30, 2011. Please follow the instructions below.

  • Antronelle Jenkins, 214-857-1699
  • Don Yeater, 214-857-1702

If you cannot reach the person assigned to your alphabet, please use either of the contact numbers listed above.

2.  Please be sure to bring with you two (2) forms of exact matching personal identification along with the completed application package with you to VANTHCS.

  • Please note that the name on the identification must match exactly (If one ID has a full middle name, and the other has a middle initial, then the initial must match).
  • One State or Federal ID must contain a photograph.
  • Both IDs must be original documents and currently valid, not expired.
  • Examples of acceptable identification includes: State-Issued Drivers License, Social Security Card, U.S. Passport, State Voter Registration Card, School ID with photograph, etc.

Please complete, print and sign the following Human Resources forms:

  • Form 10-2850D - Application for Health Professions Trainees
  • Form SF-61 - Appointment Affidavits
  • Form OF-306 - Declaration of Federal Employment
  • Form VA-0711 - Request for Personal Identity Verification Card
    Please note carefully that two forms of acceptable identity documentation are required for verification. 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). 
  • OFI Form 86C - Special Agreement Check (SAC) Special Agreement Check (SAC) Adjudication Results
  • Form I-9 – Complete Section 1, Print and Sign Employment and Eligibility Verification
  • Appointment Letter - In the second sentence list the date of your first class this year and the date of your graduation.

Please complete, print and sign the following Service Specific forms to your Service Education Program Coordinator:

Clinical Service Contact Information

If you should have any further questions or concerns trainee’s application process, please contact your service education program coordinator. If they are unable to assist you, questions regarding trainee’s application process may be directed to the VANTHCS Education Office at 214-857-1161. Unless otherwise directed by your program training coordinator, the trainee’s application packet must be completed and submitted to your education program coordinator at least six (6) weeks prior to the trainee's first rotation date.


After your completion of clinical rotation at VANTHCS, please complete the Learners' Perception Survey registration at OAA Website.

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VA North Texas Health Care System
Education Office (141)
4500 South Lancaster
Dallas, TX 75216