Va Form 0880b - Worksheet For Determining Percentages On Memorandum Service Level Expectations Page 3

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RESEARCH (List or append approved projects, indicating location of research and sponsorship (if any). Continue on the blank page 3 provided (if needed))

EXPECTATIONS RELATED TO VA APPOINTMENT

1. The service chief/manager or other appropriate supervisory official must approve changes in clinical assignments, and all clinical

assignments must be covered.

2. You must be engaged in approved VA work during your scheduled work hours.

3. All leave (annual leave, authorized absence, etc.) must be recorded. Leave must be requested and reported in advance.

4. Whenever possible, you are to submit requests for adjustments to your biweekly work requirements in advance.

DATE (Month/Day/Year)

SIGNATURE OF PHYSICIAN

DATE (Month/Day/Year)

SIGNATURE OF DESIGNATED VA OFFICIAL

CONTINUATION SHEET

VA FORM 0880b, DEC 2006, PAGE 3