Applications & Appraisals for Title 38 Health Care Positions and Trainees

OMB 2900-0205

VA Form 10-2850D, Application for Health Professions Trainees, is designed specifically to elicit appropriate information about qualifications for each trainee participating in accredited educational programs with the Department of Veterans Affairs (VA). The 10-2850D form is used by all health professions trainees, including physician and dentist residents. The collection of this information is authorized by 38 U.S.C. 7403, (Veterans’ Benefits), which provides that appointments of Title 38 employees will be made only after qualifications have been satisfactorily verified in accordance with regulations prescribed by the Secretary. Occupations listed in 38 U.S.C. 7401(1) and 7401(3) (Appointments in Veterans Health Administration), are appointed at a grade and step rate, or an assignment based on careful evaluation of their education and experience. The VA Form 10-2850D application will collect information from health professions trainees prior to VA appointment. All health professions trainees must provide information concerning their background, training, education, degrees, licensure, registrations, and other vital information to ensure appropriate qualifications for VA assignment.

The latest form for Applications & Appraisals for Title 38 Health Care Positions and Trainees expires 2022-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 10-2850e Appraisal of Applicant - VA Form 10-2850e Form and Instruction
Form 10-2850c Application for Associated Health Occupations - VA Form 10-2850c Form and Instruction
Form 10-2850a Application for Nurses and Nurse Anesthetists - VA Form 10-2850a Form and Instruction
Form 10-2850 Application for Physicians, Dentists, Podiatrists, Optometrists and Chiropractors - VA Form 10-2850 Form and Instruction
Form 10-2850d Health Professions Trainee Data Collection Form - VA Form 2850d Form and Instruction
30-Day FRN_2900-0205_Applications and Appraisals for Titles 38 Health Care Positions and Trainees_published 04072023.pdf Supplementary Document
60-Day FRN_2900-0205_Applications and Appraisals for Titles 38 Health Care Positions and Trainees_published 01202023.pdf Supplementary Document
Supporting Statement A_2900-0205_Applications & Appraisals for Title 38 Health Care Positions & Trainees_updated Apr 2023.docx Supporting Statement A
Appraisal of Applicant - VA Form 10-2850e Form and Instruction
Application for Associated Health Occupations - VA Form 10-2850c Form and Instruction
Application for Nurses and Nurse Anesthetists - VA Form 10-2850a Form and Instruction
Application for Physicians, Dentists, Podiatrists, Optometrists and Chiropractors - VA Form 10-2850 Form and Instruction
Health Professions Trainee Data Collection Form - VA Form 2850d Form and Instruction

All Historical Document Collections

202301-2900-008 Approved with change	Extension without change of a currently approved collection	2023-04-10
202001-2900-006	Extension without change of a currently approved collection	2020-11-20
201904-2900-002 Approved with change	Reinstatement without change of a previously approved collection	2019-08-13
201502-2900-007 Approved without change	Revision of a currently approved collection	2015-08-28
201203-2900-002 Approved without change	Extension without change of a currently approved collection	2012-06-15
200812-2900-007 Approved without change	Extension without change of a currently approved collection	2009-04-28
200603-2900-001 Approved without change	Revision of a currently approved collection	2006-03-02
200301-2900-005 Approved without change	Extension without change of a currently approved collection	2003-01-24
199912-2900-002 Approved without change	Reinstatement without change of a previously approved collection	1999-12-06
199909-2900-013 Withdrawn	Reinstatement without change of a previously approved collection	1999-09-13
199508-2900-012 Approved without change	Reinstatement without change of a previously approved collection	1995-08-23
199101-2900-003 Approved without change	Reinstatement with change of a previously approved collection	1991-01-11
198705-2900-002 Approved without change	Reinstatement with change of a previously approved collection	1987-05-08
198210-2900-025 Approved with change	No material or nonsubstantive change to a currently approved collection	1982-10-01
197901-2900-003 Approved without change	Revision of a currently approved collection	1979-01-26
197707-2900-002 Approved without change	Revision of a currently approved collection	1977-07-26
197706-2900-010 Approved with change	No material or nonsubstantive change to a currently approved collection	1977-06-27
197701-2900-026 Approved with change	No material or nonsubstantive change to a currently approved collection	1977-01-24

OMB Details

Applications & Appraisals for Employment for Title 38 Positions and Trainees

Federal Enterprise Architecture: General Government - Central Personnel

Form VA FL 10-341(b)	Trainee Qualification and Credentials Verification Letter (TQCVL)	vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341b-fill.pdf	Form and instruction
Form VA Form 10-2850C	APPLICATION FOR ASSOCIATED HEALTH OCCUPATIONS	vaww.va.gov/vaforms/medical/pdf/vha-10-2850c-fill.pdf	Form and instruction
Form VA Form 10-2850	APPLICATION FOR PHYSICIANS, DENTISTS, PODIATRISTS, OPTOMETRISTS AND CHIROPRACTORS	vaww.va.gov/vaforms/medical/pdf/vha-10-2850-fill.pdf	Form and instruction
Form VA FL 10-341(a)	Employment Reference for Title 38 Employee	vaww.va.gov/vaforms/medical/pdf/vha-FL-10-341a-fill.pdf	Form and instruction
Form VA Form 10-2850d	Application for Health Professions Trainees	vaww.va.gov/vaforms/medical/pdf/vha-10-2850d-fill.pdf	Form and instruction
Form VA Form 10-2850a	APPLICATION FOR NURSES AND NURSE ANESTHETISTS	vaww.va.gov/vaforms/medical/pdf/vha-10-2850a-fill.pdf	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.