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Ing a residency or fellowship program, please complete and return this form to: ECFMG Certification Verification Service 3624 Market Street, 4th Floor Philadelphia, PA 19104-2685 USA Please type or print. Requests with incomplete or inaccurate information will not be processed. USMLE /ECFMG Identification Number: Physician s Name: Date of Birth: First Day - - - Middle / Month / Last Name/Surname/Family Name Year Residency Program Name:.

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How to use or fill out the Form 186 - Fill Online, Printable, Fillable, BlankPDFfiller online

Filling out Form 186 is a straightforward process that allows you to request the certification status of international medical graduates. This guide provides step-by-step instructions to ensure accurate completion of the form online or for printing.

Follow the steps to successfully fill out the Form 186 online.

  1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
  2. Begin by entering your USMLE®/ECFMG identification number. This is crucial for tracking your application.
  3. Next, provide the physician’s name, including first, middle, and last names. Ensure accuracy to avoid processing delays.
  4. Enter the date of birth of the physician in the specified format: day, month, year. Correct formatting is essential.
  5. Specify the residency program name exactly as it appears on the official documents.
  6. Input the program ID number as listed on the ACGME website to guarantee proper identification.
  7. Fill in the address where the status report should be sent, including the name of the hospital.
  8. Complete the contact details including the contact’s name, title, phone number, and email address.
  9. Finally, review all the entered information for completeness and accuracy before submitting.
  10. Save your changes, and choose to download, print, or share the completed form as necessary.

Begin filling out your documents online for a more efficient process.

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