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Research Appointment Requirements
Credentialing and Privileging of Research Staff
Credentialing is defined as the verification of education
and experience of an employee. The method of credentialing
varies based on the appointment, i.e., VA Employee,
Without Compensation Employees (includes OHSU, PVARF,
and volunteer employees). For further information based
on the appointment, please click on the appropriate
link below.
The credentialing process must be fully completed prior
to initial appointment.
If the employee's license allows him/her to be privileged,
privileges must be granted in accordance with the facility's
Medical Staff Bylaws, Rules and Regulations prior to
performing the interventions covered under the privileges
to be granted.
Below is a list of the various research appointments
at the Portland VA.
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Click on the link for the appropriate
checklist for your job description (e.g., VA employee,
PVARF employee) AND
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complete the checklist.
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Then complete the required forms appropriate
for your appointment.
(All checklists revised
7/08)
VA
Employee (53KB, MSWord)
As a VA employee, you will need to complete the items
listed on this sheet before you can receive keys to
research areas, access patient medical files, or participate
on VA IRB-approved human research projects.
Nonpaid
Worker (67KB, MSWord)
As a volunteer, you will need to complete the items
listed on this sheet before you can receive keys to
research areas, access patient medical files, or participate
on VA IRB-approved human research projects.
OHSU
Employee (60KB, MSWord)
As an OHSU employee, you will need to complete the items
listed on this sheet before you can receive keys to
research areas, access patient medical files, or participate
on VA IRB-approved human research projects.
Vendor/Contractor
(43KB, MSWord)
As a Vendor/Contractor, you will need to complete the
items listed on this sheet before you can receive keys
to research areas, access patient medical files, or
participate on VA IRB-approved human research projects.
PVARF
Employee (61KB, MSWord)
As an PVARF employee, you will need to complete the items
listed on this sheet before you can receive keys to research
areas, access patient medical files, or participate on
VA IRB-approved human research projects.
New
Employee Education Checklist (30KB, MSWord)
Once you have completed this form, please return it
to Samantha Wise, mail code R&D, VA ext. 57161.
Scope
of Work (573KB, MSWord) Revised
4/08
The Scope of Work is specific to the duties and responsibilities
of the Principal Investigator or employee who performs
work involving human subjects under the supervision
of the Principal Investigator (PI). The PI and the
employee must complete, sign and date this Scope of
Work.
Educational
Verification Form (45KB, MSWord) Revised
2/08
All appointees meeting the following criteria who will
perform human subjects research (based on Scope of Work)
and do not meet the criteria for VetPro credentialing
or have a Resident Credentialing Verification Letter
(RCVL) Letter at Medical Staff Services Office must
complete an Education Verification Form:
- Anyone who has a short-term appointment (e.g., 3-months
or less or summer appointment).
- Anyone who does not:
Qualify for a professional license or certification
(e.g., medical license, RN license, pharmacist's license,
physical therapy, counseling, etc.).
Please contact Diane Anderson (diane.anderson@va.gov
or ext 54989) if you have any questions.
WOC
Intellectual Property Agreement (VA Web Site, MSWord)
Intellectual
Property Agreement Instructions (VA Web Site, PDF)
It is mandatory for all non-VA employees who conduct research
or have access to VA property to be on a Without Compensation
(WOC) appointment. A WOC appointment is required by federal
law and must be renewed on an annual basis. As part of
the WOC appointment processing, fingerprinting by our
local VA Human Resources Department must be completed.
To set up your fingerprinting appointment please contact
Lorraine Hillman at VA ext. 54734. The fingerprinting
process should take 15-20 minutes to complete. If you
are a non-U.S. citizen, you will need to provide citizenship
documentation at your fingerprinting appointment (acceptable
documents include a green card or certificate of naturalization).
You do not need a WOC appointment if you meet any of
the following criteria (please contact Samantha Wise,
VA ext. 57161 for confirmation):
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If you currently have a WOC through
another VA department
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If you are currently a medical resident
working at the Portland VA (please return IP agreement
only)
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If you will no longer be needing access
to VA property (e.g., keys, computers, equipment)
or to VA patients
Statement
of Commitment and Understanding (37KB, PDF)
Certificate to verify completion and understanding of
VA Cyber Security Policy and Privacy Policy (HIPAA).
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