Eye Care Team - Optometry Resident Application Materials

The following forms are required for the official appointment of residents in the Primary Eye Care optometric residency program at Portland VA Medical Center following selection through the Optrometric Residency Program Matching Service (ORMS). You will need to complete the 4 attached forms (make copies for yourself) and return them to us by June 1st. of your program year. This lead time is required for timely processing of the application through our Education Service, Medical Staff Office, and Human Resources. You will be contacted by Human Resources during the last two weeks of June. They will need to schedule an appointment with you PRIOR to July 1st. for fingerprinting and a final background check. This will only take about 30 minutes, but you will obviously need to plan on being in Portland on a week day in the later part of June.

The documents we need you to complete are:

• VA Form 10-2850b (Application for Residents)
• Optional Form 306 (Declaration for Federal Employment)
• SF 181, Ethnicity and Race Identification
• Statement of Commitment and Understanding for VA Trainees
• VA Form 10-0410 (Clinical Trainee Registration Form)
• VA Form 4637 (Employee Education Data)

Adobe Acrobat Reader is required to read these forms

Please complete these forms at your earliest convenience. You can hand-delivery them, or mail them to:

Iva Walker
Eye Care Team Program Manager
Portland VA Medical Center
P.O.Box 1034 / P-5-Eye
Portland, Oregon 97207