Additional Health Department Forms

Forms for J-1 Visa Waivers

Workforce Development
J-1 Visa Application
Form # Form Name/Title Linked File Instruction/ Comments
OPSP-1 J-1 Visa Waiver / State Conrad 30 Program - Physician-Primary Care Survey, Initial/Biannual Service Report
pdf (254k)
doc (22k)
 
OPSP-2 J-1 Visa Waiver / State Conrad 30 Program - Application for New Jersey
pdf (391k)
doc (32k)
 
OPSP-2A Attachment A: Current Medical Staffing at Practice Site
pdf (187k)
doc (18k)
 
OPSP-2B Attachment B: Health Care Resources Inventory
pdf (150k)
doc (18k)
 
OPSP-2C Attachment C: Facility Current Sliding Fee Scale
pdf (156k)
doc (16k)
 
OPSP-2D Attachment D: J-1 Physician Visa Waiver / State Conrad 30 Program - Statements
pdf (170k)
doc (17k)
 
OPSP-3 Section 4-1, Health Facility's J-1 Visa Waiver / State Conrad 30 Program - Agreement
pdf (147k)
doc (20k)
 
OPSP-4 Section 4-2, Physician J-1 Visa Waiver / State Conrad 30 Program - Affidavit and Agreement
pdf (181k)
doc (22k)
 
OPSP-5 Section 5, J-1 Visa Waiver Required Application Enclosures
pdf (175k)
doc (17k)
 
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