WebDS-2053 09-2007 OMB No. 1405-0113 ESTIMATED BURDEN: 10 minutes (See Page 2 - Back of Form) (Formerly OF-157) No Treated If treated, therapy: ... form is designed to record the result of the medical examination required by INA 221(d), which determines whether an applicant has a medical condition that WebMEDICAL EXAMINATION INSTRUCTIONS All visa applicants regardless of age need a medical examination. You must contact the examination facility listed below to schedule an appointment. The physician will not conduct an examination until you present your passport, the enclosed DS-2053, DS-3024, DS-3025, DS-3026, 1 photo and your …
U.S. Embassy Riyadh, Saudi Arabia - RID - United States Department of State
WebOct 23, 2024 · Download: pdf pdf. U.S. Department of State MEDICAL HISTORY AND PHYSICAL EXAMINATION WORKSHEET OMB No. 1405-0113 EXPIRATION DATE: XX/XX/XXXX ESTIMATED BURDEN: 15 minutes (See Page 2 - Back of Form) Photo Surnames Given Names Birth Date (mm-dd-yyyy) Document Type Exam Date (mm-dd … WebDS-2053 Vaccine history complete Incomplete vaccine history, no waiver requested Blanket waiver Individual waiver Page 2 of 2 I certify that I understand the purpose of the … huntington bank newcomerstown
I got an RFE for DS-2053 (I
WebCDC 75.17: “Notice of Arrival of Alien with Tuberculosis”; DS-2053: “Medical ... form DS-2053: Medical Examination for Immigrant or Refugee Application. Learn more. Chapter 4 - Review of Medical Examination Documentation... (Form DS-2053) or the Medical Examination for Immigrant or Refugee Applicant (2007 TB Technical Instructions) (Form ... WebAs part of the medical examination, the panel physician will complete Form DS-2053 (Medical Examination for Immigrant or Refugee Applicant – 1991 TB TIs) or Form DS-2054 (Medical Examination for Immigrant or Refugee Applicant – 2007 TB TIs) as well as a complete medical history (Form DS-3026) and all age appropriate vaccinations. WebDec 20, 2024 · OMB 1405-0113. ICR 202410-1405-004. IC 38745. Form DS-2054 Medical Examination for Immigrant or Refugee Applicant. ( ) ⚠️ Notice: This form may be … huntington bank new era