The University of Toledo

Global Health Student Forms

Global Health Student Forms  

Form 1 need to be completed if interested in participating gin a clerkship/rotation:

1.    STUDENT FORM 1: REQUEST FOR A GLOBAL HEALTH EXPERIENCE

Forms 2-5 will be completes as instructed at a pre-departure “paper work” meeting:

2.    STUDENT FORM 2: STUDENT PRE-DEPARTURE CHECKLIST

3.    STUDENT FORM 3: ACKNOWLEDGEMENT OF INFORMED CONSENT, WAIVER AND RELEASE AGREEMENT

4.    STUDENT FORM 4: PROOF of CDC-RECOMMENDED VACCINATIONS

5.    STUDENT FORM 5:  TRAVEL ITINERARY AND CONTACT INFORMATION

Form 6 is completed by the student on your return trip home:

6.   STUDENT FORM 6:  STUDENT EVALUATION OF PROGRAM