Use this step-by-step guide to complete the CIEE Physician Medical Report Form correctly. Following these steps ensures your PDF submission is accepted by CIEE support staff and that your program application moves forward without delays.
Step 1: Fill In the Applicant Information Section
Begin by completing your section of the form. Enter your full legal name, date of birth, home address, CIEE program name, and program start date. Include any additional details your specific program coordinator has requested. Review all entries for accuracy before presenting the form to your physician, as errors in this section can cause processing delays with CIEE support.
Step 2: Select a Qualified Physician
Contact a licensed physician to conduct your medical examination and complete the PDF. CIEE policy requires the examining physician not be your parent or legal guardian. This requirement exists to ensure an objective, independent assessment of your health. A general practitioner, family physician, or any licensed medical doctor who is not related to you can complete this form. If you are unsure which physician to contact, check with your healthcare provider or a local medical clinic for guidance.
Step 3: Undergo the Medical Examination
Schedule and attend a full medical examination with your chosen physician. The examination typically covers your vital signs, health history, current prescription medications, immunization records, and any physical or psychological conditions. The physician must complete their section of the CIEE Physician Medical Report Form based on a current examination conducted within four months of your program start date. If the physician needs to include additional medical information, they can attach a separate sheet to the completed PDF.
Step 4: Submit the Completed Form
After the physician signs and dates the completed CIEE Physician Medical Report Form, submit the PDF to your program coordinator before the required deadline. You can typically find submission deadline information on the CIEE resources page for your specific program. CIEE support staff will review the form and contact you if any follow-up documentation is required. Keep a copy of the completed PDF for your personal records as security documentation during your study abroad program.
FAQ - Common Questions About the CIEE Medical Form
Can a parent who is also a physician complete the form?
No. CIEE specifically prohibits a parent or legal guardian from completing this form, even if they are a licensed physician. An objective, independent medical assessment is required to ensure participant health and safety.
How old can the medical examination be?
The physical examination must take place within four months of the CIEE program start date. An older examination will not be accepted. Contact your program coordinator to confirm the specific deadline for completing your medical evaluation.
What if I have a chronic medical condition or take daily medications?
Disclose all conditions, treatments, and medications in the relevant sections of the PDF form. CIEE support staff are experienced in reviewing participant medical information and will contact you directly if additional documentation or accommodations are needed. Your personal health information is handled in accordance with applicable privacy and legal requirements.
What resources are available if I have questions?
For support and guidance on completing the CIEE Physician Medical Report Form, contact your assigned program coordinator. Additional information and resources for international study participants are available on the official CIEE website. For other related medical forms, visit the Medical Physician Order Form and Medical Report Form.