Private Physician Appointments

All students except those going to Ghana, India, and South Africa have the option of obtaining their clearance either from UCSB’s Student Health Service or from a private physician.

If you decide to use a private physician, then you must follow the instructions below exactly as written. It is your responsibility to complete the process by the deadlines you have been given in your packet. There are 2 forms you must bring with you to your appointment.

1. Complete the student Confidential Health History form that was given to you with your selection letter. You must fill out this form completely (including the dates of your childhood immunizations) BEFORE seeing the doctor because the information on it will be used for your clearance consultation.
   
2. Obtain the form Health Clearance for Students Planning to Study Abroad from the UCSB Campus EAP Office. This form includes instructions to the physician for completing the health clearance.
   
3. Make an appointment with your doctor AND any specialist you may be seeing for a serious, ongoing condition, and take BOTH of the above forms with you. Give the forms to the doctor and ask him or her to follow the instructions on the clearance form carefully. BE SURE TO SIGN the “Authorization for Release of Medical Information” on the health clearance form upon completion of the consultation.
   
4. SEND the completed original, plus one copy, of the Health Clearance for Students Planning to Study Abroad form to:
   
   The Universitywide Office of the Education Abroad Program
   6950 Hollister Avenue, Suite 200
   Goleta, CA 93117-5823
   
   UOEAP must receive this form at least 60 days before departure in order for you to participate in the program abroad. Your health practitioner will keep a copy for his/her records.
   
5. LEAVE a copy of the Confidential Health History form with your doctor, so that he or she will have it on file in case of emergency. Keep the original plus several copies for yourself and be sure to take them with you when you go abroad. You will have the only copies of this form at the program site should you need medical attention. EAP does not receive a copy of this form.
   

NOTE: If you have any physical impairment, learning disability or other condition, for which you will be seeking accommodation abroad, have your campus Disabled Students Office send a memo to the UCSB campus EAP Office and the Universitywide Office of the Education Abroad Program indicating the condition and your needs. Universities abroad will require this memo before special arrangements — i.e. granting extra time for tests, arranging for special facilities or assistance — can be considered.