VA Boston Healthcare System

Here you will find instructions and forms for:

• Undergraduate nursing student programs
• Graduate nurse student programs
• Surgical and medical technician student programs
• Certified nursing assistant, high school-based programs
• Affiliating Faculty (patient contact and no patient contact information)

Directions to VA Boston Healthcare System and Shuttle Schedules

Please note that you may need to download viewers to access the forms listed below. If so, visit http://www.va.gov/viewers/ for more information.

Undergraduate and Pre RN Licensure Students

1. Instruction Guidelines
   a.  Undergraduate Nursing FIRST time student instructions
   b.  Checklist of requirements 
2. VA ID Personal Identification Verification (PIV)
3. Health Information template 
4. Online Orientation (VA National test)
   a.  VHA Mandatory Training for Trainees (Separate instruction sheet provided) please print and bring certificate of completion
   b.  Massachusetts Centralized Clinical Placement Online Orientation (print ticket and bring)
   c.  VA Boston Healthcare System orientation supplement for clinical trainees (print and sign page 14)
5. Administrative Credentialing Forms 

a.  I9 form
b.  612 form
c.  statement of commitment
d.  306 form (2 copies)

  6.  Fingerprinting

Fingerprinting will be arranged by Nursing Affiliation staff, unless otherwise notified.  Each student is required to be fingerprinted.  Fingerprinting must be completed prior to any clinical placement.

-- Brockton - contact telephone 774-826-1164 or 774-826-1119

-- Jamaica Plain - contact 857-364-5562 or 857-364-5561

-- West Roxbury - contact 857-203-6064 or 857-203-6252

Available all day by appointment.

  7.  Computer Application Class

a.  Will be scheduled for you by Nursing Affiliation staff.
b.  You will not be allowed to attend until steps 1-4 have been fulfilled.
c.  Need social security number submitted with health information so that computer access codes may be requested.
d.  Computer access codes will be given to you at the time of your scheduled class.
e.  Arrive to your scheduled computer application class 10 minutes prior to start time for registration.

Returning Undergraduate Students

      Instruction Guidelines 

Graduate students:

1. Instruction Guidelines
   a.  Graduate Nursing FIRST time student
   b.  Checklist of requirements 
2. VA ID Personal Identification Verification (PIV)
3. Health Information template
4. Online Orientation (VA National test)
   a.  VHA Mandatory Training for Trainees (Separate instruction sheet provided) please print and bring certificate of completion
   b.  Massachusetts Centralized Clinical Placement Online Orientation (print ticket and bring)
   c.  VA Boston Healthcare System orientation supplement for clinical trainees (print and sign page 14)
5. Administrative Credentialing Forms

a.  I9 form
b.  2850a RN Application
c.  statement of commitment
d.  306 form (2 copies)
e.  RN License
f.   BLS card

  6.  Fingerprinting 

Fingerprinting will be arranged by Nursing Affialiation staff, unless otherwise notified.  Each student is required to be fingerprinted.  Fingerprinting must be completed prior to any clinical placement.

-- Brockton - contact telephone 774-826-1164 or 774-826-1119
-- Jamaica Plain - contact 857-364-5562 or 857-364-5561
-- West Roxbury - contact 857-203-6064 or 857-203-6252

(Available all day by appointment)

  7.  Computer Application Class

a.  Will be scheduled for you by Nursing Affiliation staff.
b.  You will not be allowed to attend until steps 1-4 have been fulfilled.
c.  Need social security number submitted with health information so that computer access codes may be requested.
d.  Computer access codes will be given to you at the time of your scheduled class.
e.  Arrive to your scheduled computer application class 10 minutes prior to start time for registration.

Returning Graduate Students

Surgical/Medical Assistant Technician Undergraduate Students:

1. Instruction Guidelines
   a.  Undergraduate FIRST time student instructions
   b.  Checklist of requirements 
2. VA ID Personal Identification Verification (PIV)
3. Health Information template
4. Online Orientation (VA National test)
   a.  VHA Mandatory Training for Trainees (Separate instruction sheet provided) please print and bring certificate of completion
   b.  Massachusetts Centralized Clinical Placement Online Orientation (print ticket and bring)
   c.  VA Boston Healthcare System orientation supplement for clinical trainees.  (print and sign page 14) 
5. Administrative Credentialing 

a.  I9 form
b.  612 form
c.  statement of commitment
d.  306 form (2 copies) 

  6.  Fingerprinting 

Fingerprinting will be arranged by Nursing Affiliation staff, unless otherwise notified.  Each student is required to be fingerprinted.  Fingerprinting must be completed prior to any clinical placement.

-- Brockton - contact telephone 774-826-1164 or 774-826-1119
-- Jamaica Plain - contact 857-364-5562 or 857-364-5561
-- West Roxbury - contact 857-203-6064 or 857-203-6252

(Available all day by appointment)

Certified Nursing Assistant Students and High School Students:

1. Credentialing Instruction Sheet
2. Health Information template 
3. Administrative Credentialing Forms

a.  I9 form
b.  612 form
c.  306 form (2 copies)
d.  Fingerprinting (under 18 parental consent form)

  4.  Fingerprinting 

Fingerprinting will be arranged by Nursing Affiliation staff, unless otherwise notified.  Each student is required to be fingerprinted.  Fingerprinting must be completed prior to any clinical placement.

Faculty (First Time Clinical Faculty Non-VA):

1. Instruction Guidelines
   a.  Faculty Instructions
   b.  Checklist of requirements 
2. VA ID Personal Identification Verification (PIV)
3. Health Information template 
4. Online Orientation (VA National test)
   a.  VHA Mandatory Training for Trainees (Separate instruction sheet provided) please print and bring certificate of completion
   b.  Massachusetts Centralized Clinical Placement Online Orientation (print ticket and bring)
   c.  VA Boston Healthcare System orientation supplement for clinical trainees.  (print and sign page 14)
5. Administrative Credentialing Forms

a.  I9 form
b.  2850a RN Application
c.  statement of commitment
d.  306 form (2 copies)
e.  RN License
f.   Clinical instructor profile
g.  BLS card
h.  Letter of recommendation from affiliating school
i.   Original sealed transcripts

  6.  Fingerprinting 

Fingerprinting will be arranged by Nursing Affiliation staff, unless otherwise notified.  Each student is required to be fingerprinted.  Fingerprinting must be completed prior to any clinical placement.

-- Brockton - contact telephone 774-826-1164 or 774-826-1119
-- Jamaica Plain - contact 857-364-5562 or 857-364-5561
-- West Roxbury - contact 857-203-6064 or 857-203-6252

(Available all day by appointment)

  7.  Computer Application Class and Barcode Medication Administration Class

a.  Will be scheduled for you by Nursing Affiliation staff.
b.  You will not be allowed to attend until steps 1-4 have been fulfilled.
c.  Need social security number submitted with health information so that computer access codes may be requested.
d.  Computer access codes will be given to you at the time of your scheduled class.
e.  Arrive to your scheduled computer application class 10 minutes prior to start time for registration.

Returning Faculty:

      --Instruction Guidelines
Faculty No Patient Contact:        

      --Instruction Guidelines 

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