Global Health Program

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 (Word Doc)


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 (Word Doc)


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 (Word Doc)

Student Form 2: Acknowledgement of Informed Consent, Waiver and Release Agreement (Word Doc)

Student Form 3: Proof of CDC-Recommended Vaccinations (Word Doc)

Student Form 4: Travel Itinerary and Contact Information (Word Doc)

Last Updated: 7/18/19