Private Physician

*If there is a cost associated with your health clearance process and your program gets canceled, fees paid for this process will NOT be refunded to you.

1. If your program offers you the option to obtain your health clearance with a Private Physician (refer to the health clearance chart) and if you wish to pursue this, follow these instructions.

2. Students that do not have a private physician in the local Santa Barbara area may also go to a local clinic such as :

Fairview MedCenter (by Bed Bath and Beyond) Isla Vista MedClinic
271 N. Fairview Ave - Goleta 970 Embarcadero del Mar - Isla Vista
Step 1:   Schedule an appointment with a private physician / local clinic 
Make an appointment with a private physician and any specialist you are seeing for an ongoing condition. Specialist clearance should be completed BEFORE the general practioner clearances. 
The UCEAP Health Clearance Form consists of 2 sections: specialist (if applicable) and general physician.
Step 2:   Print out health forms 
1) Carefully check your program's pre-departure requirements section found in your UCEAP Portal to determine if there are country-specific health forms that you will need to print out and bring to your appointment.

2) Print out the UCEAP Confidential Health History Form, complete it and bring it to your appointment. You will need your immunization records for the form.

3) Print out the UCEAP Health Clearance Form and bring it to your appointment for the physician to complete.

Step 3:   Attend your appointment
1)  Bring all necessary forms and make sure to get them completed and signed.
Step 4:   Submit your health clearance form on time 
1) Make a copy of the form for your files.

2) Submit to the UCEAP office so it arrives by the deadline using the following methods:

    a) Mail the original of the completed form to:
        UCEAP System Wide Office
        [Specify your UCEAP country and program name here] 
        6950 Hollister Avenue, Suite 200
        Goleta, CA 93117

     b) FAX to 1+805-893-2583

     c) Email to [specialist/advisor email address].
         IMPORTANT NOTE: Using non-encrypted email to send yourcompleted health clearance is not
         private or secure. Also, there is a possibility that the email could be intercepted and read by
         others whom you did not intend to receive it.

UCEAP must receive this form at least two months before official program start date to prevent delays in participation*.
*Except Chile: The Consulate of Chile in Los Angeles requires that clearances be completed and dated 30 days, or less, before your visa application date.
The Consulate in San Francisco does not have this requirement.

Confidential Health History - Do not send a copy to the UCEAP Systemwide Office.
     a) Leave the completed original form with your doctor for your file, if possible.
     b) Take a copy with you abroad in case you need to provide a medical history in an emergency.