Global Health Program

Global Health Program

Resources For Students:

Resources For Residents:

Resources For Faculty:

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Contact Us

Main Campus
Snyder Memorial

Suite 1000
Phone: 419.530.2549
Fax: 419.530.5266

Global Health Student Forms

Congratulations on participating in an approved University of Toledo College of Medicine and Life Sciences' Global Health elective/medical mission! Download the elective checklist to make sure you complete all appropriate forms and actions:

Student Pre-Departure Checklist


Form 1

This form needs to be completed now, if interested in participating in a clerkship/rotation:

STUDENT FORM 1: REQUEST FOR GLOBAL HEALTH EXPERIENCE


Forms 2-4

These forms will need to be completed later, as instructed at a pre-departure “paper work” meeting. Utilize this Student Pre-Departure Checklist as a guide

 STUDENT FORM 2: ACKNOWLEDGEMENT OF INFORMED CONSENT, WAIVER AND RELEASE AGREEMENT

STUDENT FORM 3: PROOF of CDC-RECOMMENDED VACCINATIONS

 STUDENT FORM 4:  TRAVEL ITINERARY AND CONTACT INFORMATION


Post-Trip Evaluation

This form is completed by the student on your return trip home:

STUDENT EVALUATION OF PROGRAM

Last Updated: 12/22/17