Medical Clearance to Race Form - bausapbabbcombau 2025

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The medical clearance is based upon the employee participating in a complete head-to-toe physical examination, a complete blood panel, a health history questionnaire, an EKG, vision test, pulmonary function test, hearing test, and a stress test for those over the age of 40 or at the discretion of the provider.
Fill out the DS-1843 form. Fill out the DS-6570 (Pre-Deployment Physical Acknowledgement form). Have a medical provider conduct a physical examination and complete and sign the DS-1843 and DS-6570. Submit the completed DS-1843 and DS-6570 via email as a PDF to MEDMR@state.gov or fax it to 202-647-0292.
Get your clearance letter after a telehealth visit We review everything with you during a 10 to 30 minutes visit with our clinical team. Access our team of pre-surgery expert clinicians by booking your appointment for a video visit.
Obtain Physical Examination: Obtain a physical exam for you and any accompanying EFMs from a licensed provider (i.e., a Physician Assistant, Nurse Practitioner, Doctor of Medicine, or Doctor of Osteopathic Medicine), who must complete and sign the DS-1843 /DS-1622 forms.
Timely Return-to-Work Clearance Urgent care centers are designed to provide prompt medical services, often with shorter wait times compared to primary care providers.
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