Get Form I-910, Application For Civil Surgeon Designation, Is Used By Physicians Seeking Designation As

Filling out the Form I-910 is a crucial step for physicians seeking designation as civil surgeons, authorizing them to conduct immigration medical examinations for application seekers. This guide provides clear, step-by-step instructions for completing the form online.

Follow the steps to successfully complete the Form I-910 application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Carefully read the instructions provided before starting to fill out the form. This ensures you understand the requirements and sections involved.
3. Fill out Part 1, which includes your full name, date of birth, and any previous civil surgeon designations if applicable.
4. In Part 2, provide information about the clinical office locations where you intend to conduct immigration medical examinations. Ensure the provided addresses are accurate and current.
5. Complete Part 3 by detailing your status in the United States. Indicate whether you are a citizen, permanent resident, or in another status that allows you to work.
6. Move to Part 4 and list your medical degrees, including the name of the school, graduation dates, and type of degree.
7. In Part 5, provide details regarding your medical licenses, including the issuing state, license number, dates issued, and ensure to denote their active status.
8. Document your professional experience in Part 6, showing at least four years of practice. Include employers’ names, dates, and contact information.
9. Complete Part 7 by signing and providing your contact information, ensuring that your signature is valid and properly dated.
10. If applicable, have your interpreter complete Part 8, while noting anyone who assisted in preparing your application in Part 9.
11. If you require additional space for any details, utilize Part 10 for further explanations or attach separate sheets, detailing necessary information.

Take the next step toward your civil surgeon designation by completing the Form I-910 online today.