Loading
Get Six Month Reporting Form
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Six Month Reporting Form online
This guide provides a professional and user-friendly approach to completing the Six Month Reporting Form online. It offers step-by-step instructions to help users navigate the form efficiently and accurately.
Follow the steps to complete the form online:
- Press the ‘Get Form’ button to retrieve the form and open it in the online editor.
- In the section labeled 'THIS SECTION TO BE COMPLETED BY THE PHYSICIAN ON THE J-1 VISA WAIVER', begin by entering the 'Six (6) Months Work Period'. This is a critical field that indicates your reporting timeframe.
- Next, provide the 'Name of Physician' and confirm the state as 30 or ARC.
- Fill in the 'Sponsor’s Name' to identify the sponsoring organization.
- Record the 'Original Date of Employment'. This information is vital for establishing your tenure.
- For the 'Primary Practice Site', enter the 'Name of Site' and the 'Location Address', followed by the 'City/State/Zip/ County'.
- Indicate the number of hours per week the physician engages in patient care at this primary location.
- If applicable, list any additional practice sites. For each site, include the 'Name of Site', 'Location Address', and 'City/State/Zip/ County', as well as the hours worked here.
- Respond to whether the physician works at any additional sites and, if necessary, note this in the margin or attach further information.
- Specify the percentage of practice that serves Medicaid patients and the percentage billed on a sliding fee scale.
- Document the amount of time the physician was absent from this position due to reasons such as illness or vacation.
- In the following section labeled 'THIS SECTION TO BE COMPLETED BY SPONSOR', the sponsor should provide their name and the name of the practice.
- Enter the 'Sponsor’s Mailing Address', followed by 'City/State/Zip' and 'Phone Number'.
- Both the sponsor and the physician must sign and date the respective fields, certifying the accuracy of the information provided.
- Finally, save any changes made to the form, and proceed to download, print, or share the completed document as required.
Complete your Six Month Reporting Form online today to ensure timely submission.
Both the student and their employer should complete the pages of the Form I-983. The student provides their personal details, while the employer supplies information about the training and its relevance to the student's field of study. This collaboration ensures accuracy and completeness when submitting the Six Month Reporting Form.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.