Ds 3057-2025

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The document is a Medical Clearance Update form from the U.S. Department of State's Bureau of Medical Services, intended for individuals eligible to participate in the Department's Medical Program while assigned abroad. It outlines the purpose of collecting medical information, privacy notices, and instructions for completing the form. The form requires personal and medical history details, including current medications and any new medical conditions since the last clearance. It emphasizes voluntary disclosure but warns that failure to provide information may affect medical clearance eligibility.

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Click ‘Get Form’ to open the ds 3057 in the editor.
Begin by filling out the demographic information on page 1. Enter your name, date of birth, and sex in the designated fields.
Indicate your status (Employee, Spouse, or Dependent Child) and provide your health insurance plan details.
Complete the contact information section, including telephone number and email address where you can be reached for the next 90 days.
On page 2, answer all medical history questions thoroughly. Attach additional pages if necessary for detailed responses.
Review your entries for accuracy and completeness before signing at the bottom of the form.
Once completed, scan the signed form and submit it via email in PDF format to MEDMR@state.gov.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (91 Votes)
2017	4.4 Satisfied (107 Votes)
2014	4.3 Satisfied (42 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How long does a medical clearance take for a job?

However, notice of the applicants medical status from the contracted clinic may take up to 10 business days from the date of the medical examination. In some cases, the process can be extended longer due to the need to review and consider additional information or personal medical records from the applicant.

How long does a medical clearance take?

It is difficult to tell how long a pre-employment check will take because not all of them are done in the same way, and it also depends on the number of tests required. Nevertheless, it can take 3 to 4 weeks on an average.

How do I prepare for medical clearance?

A successful clearance and surgery starts with a good preparation Signup Book your visit. Answer a set of questions to prepare your visit. Get your test done when you want with Quest or Labcorp. Get your clearance letter after a telehealth visit. Get 24/7 access support before your surgery. And after your surgery.

What does it mean to be cleared medically?

The term is often used by surgeons requesting a medical evaluation before performing surgery on a patient. In the context of surgery, a medical clearance is, essentially, considered to be an authorization from an evaluating clinician that a patient is cleared, or deemed healthy enough, for a proposed surgery.

How to get a medical clearance letter?

Obtain the Medical Clearance Form from your healthcare provider or the institution requiring it. Fill in your personal information, including your name, date of birth, and contact details. Provide details of your medical history, including any existing conditions, medications, and previous surgeries.

state medical clearance

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What does a medical clearance exam consist of?

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.