Education Abroad Medical Form

Please complete the following form. If the question does not apply to you, please write none or N/A.

  • Pay special attention to the vaccination requirements for your destination. If you do not have the vaccination required, you must: attain it by December 1st, update your health portal, provide prove to Health Services that you received the vaccination and provide a print out of your completed vaccination history to your program lead.

         2020 Vaccination Requirements by Destination

  • When providing your digital signature at the end, note that you are attesting that the information on this form is accurate and complete. You are also agreeing to share this form with program supervisors and rates.
 
1 Start 2 Health History 3 Contacts 4 Complete
4 + 0 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.