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Forms

Most of the listed forms are in PDF format and can be downloaded to your computer in Adobe Acrobat Reader, which is available free. Please contact the Office of Global Health Programs if you are unable to download any of the forms.

Application Forms & Links

  • Application for all programs. An EAIS application is required for all students, preceptors and non-OU employees applying to participate in OHIO faculty director programs, HCOM Independent International Rotations and some other independent global health opportunities.­ Application deadlines vary by program and are noted on the program page.
  • Supplemental Application.­ Third and Fourth Year HCOM Students participating in an independent international rotation must also complete the supplemental application as part of the approval process for their rotation.
  • Ecuador Primary Care Clinical Elective Essay.­ This essay is required as part of the application process for the­Ecuador Primary Care Clinical Elective Program.
  • Non-Degree Application.­ This online application is required for all non-OHIO University students, volunteers, advisors or employees before application to a global health program. The application fee is waived.­­You­will receive­a­PID­Number­after­application from the­Global­Health­Office.­­You­will then­activate­an­OHIO e-mail address at https://www.ohio.edu/myid.­ You will need the PID Number and date of birth to receive your OHIO e-mail which is also your OHIO ID used­to apply for a program.­
  • Affiliated Travel Packet.­ First or second year HCOM students and HSP students completing an independent study or research trip affiliated with OU without credit are asked to register their trip by completing the Affiliated Travel Packet.­ For first and second year HCOM students this includes trips organized through third party providers such as ISL or CFHI.­ This packet includes the STEP registration form and the HTH Health Insurance application.
  • Foreign Study Checklist. This link provides instructions to HSP students participating in Ohio Exchange and non-Ohio Programs for credit.­ This includes participating in programs through third-party providers. Go to "Non-OU Program (for credit)".­ The Foreign Study Checklist can also be obtained at the Office of Education Abroad in Walter International Education Center.
  • HTH Worldwide Health Insurance & SOS Enrollment.
  • Visa. Links to the U.S. Department of State and lists requirements for entry by country and country embassy websites.
  • Smart Traveler Enrollment Program. Links to the U.S. Department of State so you can register your trip so that the Department of State can assist you in an emergency.­ Please remember to print or copy your information before you click submit and send a copy to the the Office of Global Health Programs along with the Confirmation of STEP Enrollment. ­­
  • Guidelines for Ethical Practice. All students participating in Global Health programs are required to indicate that they have read these ethical guidelines by signing and returning the last page of the form.

Preceptor Forms

  • Clinical Preceptor Checklist­& Agreement.­ Reviews the paperwork needed to apply as a clinical preceptor for Global Health Programs.­ Depending on the program and participant makeup, preceptors can be medical residents, licensed physicians or other licensed healthcare workers.
  • OU-COM CORE Faculty Profile.­ Licensed physicians and medical residents participating as preceptors, must apply as OU-HCOM Faculty to participate in Global Health programs.

Pre-departure Forms

  • Checklist - general checklist of required documents to aid in your travel preparations
  • Pre-Departure Packet

Post Program Forms

  • Evaluation - Please complete this online evaluation after you return.

Undergraduate Certificate in Global Health Forms

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Please return all forms to the Office of Global Health Programs:

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E118 Grover Center

Athens, OH­ 45701

Email: globalhealth@ohio.edu

Phone:­ 740-593-2359

Fax:­ 740-593-2320

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Please feel free to contact the Office of Global Health if you have any questions.

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