CONSENT TO JOIN CLASS ACTION LAWSUIT
TO: CLERK OF COURT AND COUNSEL OF RECORD
state the following:
  1. I am over 18 years of age and competent to give the following consent.
  2. I am currently or was formerly employed by the Department of Veterans Affairs (“VA”) as an Advanced Practice Registered Nurse (“APRN”) or Physician’s Assistant (“PA”) at the following VA healthcare facility or facilities during the time periods identified below:

  1. I understand that in order to be a member of the class, I must have worked at the facility/facilities identified above at some point between August 24, 2012, and the present.
  2. I understand that the Court has certified a class action that has been filed against the VA on behalf of APRNs and PAs who claim to be owed unpaid overtime and premium pay for work managing view alerts and electronic patient health records in the VA’s Computerized Patient Record System (“CPRS”) before or after their tours of duty, including weekends and holidays when such work occurred.
  3. I believe the VA has not paid me for all time I have been induced to work before or after my tours of duty, or on weekends or holidays, to manage view alerts and electronic patient health records in CPRS.
  4. I hereby consent and agree to opt into and join this lawsuit as a claimant and to be bound by any adjudication by the Court or settlement of the case approved by the Court.
I swear or affirm that the foregoing statements are true to the best of my knowledge, information and belief.
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