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HomeMedical Clearances...Forms – Medical Clearances

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Forms

DS-1843: Medical History and Examination For Individuals Age 12 and Older
DS-1622: Medical History and Examination For Children Age 11 and Younger
DS-3057: Medical Clearance Update (MCU) Form
DS-6570: ESCAPE Posts Pre-Deployment Physical Exam Acknowledgement Form
MED ISO 3003: Health Unit Access and Provision of Limited Medical Services to Unpaid Short-term or Seasonal Interns
MED ISO 3308: DOD Civilian and DOD Contractor ICASS Verification Letter
MED ISO 3308.5: Institutional Contractor ICASS Verification Letter
MED: Medical Records Coversheet

U.S. Department of State