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Ds 1843-2026

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  1. Click ‘Get Form’ to open the ds 1843 in the editor.
  2. Begin by filling out the Demographic Information section. Enter the examinee's name, date of birth, and other required details accurately.
  3. Proceed to the Medical History section. Answer each question truthfully, providing explanations for any 'Yes' responses in the designated box.
  4. List all current medications in Section III, ensuring you include dosage and frequency for clarity.
  5. Complete Section IV regarding hospitalizations and operations. Be thorough in detailing any relevant medical history.
  6. Review your entries for accuracy before signing on page 2. Ensure all necessary laboratory tests are attached as specified.
  7. Submit your completed form via email in PDF format to MEDMR@state.gov or fax it to the Medical Records Department.

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Your provider will check vital signs, listen to your heart and lungs, and assess your overall health. These may include bloodwork, urinalysis, or other labs tailored to your condition and procedure. Depending on your needs, you may be referred for an EKG or chest X-ray to rule out complications.
Basic Evaluations: Without tests, it may take up to 12 days. Comprehensive Clearances: If lab tests or imaging studies are required, may take several days.
The Department of State has identified certain posts as Employee Self-Certification and Ability to Perform in Emergencies (ESCAPE) posts. ESCAPE posts comprise a subset of High-Threat, High Risk (HTHR) posts.
Review your medication list, with recommendations for how to take your medications prior to surgery. Review your medical, surgical and family history. Include a physical exam. If necessary, complete additional preoperative testing following your exam, including blood tests, tests, X-rays or an EKG.
A medical clearance enables these individuals to access Department health care benefits and services while posted abroad. Benefits include, but are not limited to, access to the post Health Unit, medical evacuation travel, and secondary payer coverage for hospitalizations.

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A: Confirmation Receipt from Online Booking. One (1) Fully Accomplished BOQ PE Form 2: Medical Exam for Local Applicants (To be filled up at BOQ) 11 ID Picture with White Background (Three (3) pieces for New Application and Two (2) pieces for Renewal) Previous Health Card (For Renewal Only)

ds 1843

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Title: Principles of the interior or hidden life : designed particularly for the consideration of those who are seeking assurance of faith and perfect love.Read more

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MEDICAL HISTORY AND EXAMINATION

Submit the DS-1843 and other documentation via email in PDF format to MEDMR@state.gov (preferred), or by fax to the Medical Records Department at 202-647-0292.Read more

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