Saint Francis IMM Required Travel Forms

Once you have been accepted as a possible member of an upcoming Saint Francis Medical Mission Team, the next step is to fill out the paperwork on this post.The more our organization grows, and the farther we travel, documentation becomes an ever increasing necessity for safety and record keeping. We enjoy a close relationship with the Administration of Saint Francis Hospital, and they require these forms be filled out and returned. Failure to do so means you will not be allowed to travel with us. Please download and complete the required Saint Francis International Medical Missions forms. The medical director or credentialing organizer for your trip will tell you where to mail the forms. Make a folder for your trip, and keep a copy of each of these records for yourself. The liablility release form must be notarized.

HIPPA Mission Media Release Form (PDF)

HIPPA Mission Media Release Form – Spanish (PDF)

HIPPA Mission Media Release Form – Haitian (PDF)

SFH Participation Request Form (PDF)

SFH IMM Travel Release (General) (PDF)

SFH IMM Travel Release (Haiti) (PDF)

SFH IMM Health Form (PDF)

SFH IMM License Letter (PDF)

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