Form 182 ecfmg 2026

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Click ‘Get Form’ to open it in the editor.
Begin by entering your current name as it appears in your ECFMG record in the designated fields for First Name(s), Middle Name(s), and Last Name(s).
If you are requesting a name change, check the appropriate box and provide your new name along with a reason for the change. Ensure you attach the required documentation.
For date of birth corrections, enter your current date of birth and check the corresponding box. Provide the new date of birth and a reason for this correction, along with supporting documents.
Sign the form where indicated using the Latin alphabet and include the date of signing. Review all entries for accuracy before submission.
Submit your completed form via fax or mail to ECFMG as instructed on page 3.

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