Additional Health Department Forms

Forms for J-1 Visa Waivers

Workforce Development
J-1 Visa Application
Form # Title PDF/WORD 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
 
Go to J-1 Visa Waivers     Additional Health Department Forms