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Providence VA Medical Center, Rhode Island


Education - Student Nursing Clinical Placement Checklist

Listed below are all the required forms and processes you must review and/or complete and return to the Providence VA Medical Center (PVAMC) Nursing Office NO LATER THAN 4 WEEKS PRIOR to your clinical experience. Please closely follow the instructions. If you have any questions or concerns about the process or the forms please contact Ashiki Robinson or Sabrina Estrada at (401) 273-7100 ext. 4372 or 2130.


Step 1

Student completes all of the below bulleted forms in ink- INCLUDING the ones entitled “optional”. Forms must be received at the VA 4 WEEKS PRIOR to the first day of your clinical rotation:

NOTE: IF YOU WERE NOT U.S. BORN, please include a photocopy of a citizenship document to show you are legal to be in the U.S., i.e. naturalization certification, resident alien card, passport, etc.  The photocopy must be legible.

Please ensure all forms are signed and dated prior to mailing.
Forms Do Not need to be notarized.


Step 2 

Submit to:

Providence VA Medical Center OR mail them to Attn: Ashiki Robinson

PVAMC                                                                Nursing Service (118)
Nursing Service                                                   Providence VA Medical Center  
7th floor, room 725                                             830 Chalkstone Ave.
                                                                         Providence, RI  02908.             

After ALL paperwork is submitted and reviewed, you will be contacted by the Nursing Department to make appointments to process in through Human Resources (HR) for fingerprinting and photo ID at least two weeks prior to the first day of your clinical rotation. You will need two forms of ID on that day. Use the link to the list of acceptable IDs list

Complete Steps 1 and 2 before starting Step 3

Step 3 

Step 3

  • All students must complete the on-line course ‘Mandatory Training for Trainees’ (please allow up to 2-4 hours for this training)
  • The embedded attachment has directions - VA Mandatory Training for Trainees
Step 4

 Step 4

Students on Independent Clinical Rotations or Leadership Rotations: You will be contacted to schedule an appointment for fingerprinting and photo ID badge after application forms are received.

** If you have any questions or concerns about the process or the forms, please contact the Nursing Department at (401) 273-7100, extension 4372 or 2130.

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