Updated Visa Medical Examination Forms

Reference Document: STATE 066548, 06/09

TO ALL DIPLOMATIC AND CONSULAR POSTS

1. Updated visa medical forms are now available [Redacted (intranet/internal web address)].

2. The forms are:

-- DS-2053 - Medical Examination for Immigrant or Refugee Applicant (1991 TB TIs)

-- DS-2054 - Medical Examination for Immigrant or Refugee Applicant (2007 TB TIs)

-- DS-3024 - Chest X-Ray and Classification Worksheet (1991 TB TIs)

-- DS-3030 - Chest X-Ray and Classification Worksheet (2007 TB TIs)

-- DS-3026 ? Medical History of Physical Examination Worksheet (all posts), and

-- DS-3025 ? Vaccination Documentation Worksheet (all posts).

3. All posts should begin using the DS-2053, DS-3024, DS-3026, and DS-3025 forms immediately, and discontinue use of any older version of these forms. The Consular Section must ensure that copies of the updated forms are provided to all panel physicians. Medical exams which have been completed using the older version of the forms do not have to be repeated.

4. The new DS-3054 and DS-3030 reflect the changes and updates to the Centers for Disease Control and Prevention (CDC) Technical Instructions (TIs).  CDC is currently in the process of rolling out the 2007 Tuberculosis (TB) TIs to all posts.

5. For more information about the changes and a list of posts currently designated to use the new TIs, see http://www.cdc.gov/ncidod/dq/panel_2007.htm.  All posts where screening for tuberculosis is being performed according to the 2007 TB TIs should begin using the DS-3054 and DS-3030 on October 1, 2009. Medical exams which will have been completed using the DS-2053 and DS-3024 by October 1, 2009 will not need to be repeated.

6. The appropriate sections in 9 FAM 40.11 Notes and Exhibit I, 41.108 Notes, 42.66 Notes, and 9 FAM Appendix O will be updated to reflect these changes.

7.  For any consular procedural questions on the forms, please contact [redacted] VO/F/P.

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