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Arizona State 30 J-1 Visa Waiver Program
 
HSD Contact: Fabian Valle (Contact Us)
  
 

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NEWS:

The Arizona Department of Health Services J-1 Visa Waiver program will begin accepting applications for the 2009 program cycle on October 1, 2008. Primary Care or Specialty physicians requesting consideration for a letter of support must submit applications post-marked no later than Saturday, November 29, 2008.

The application review process takes approximately six to eight weeks from the closing of the program. In the event additional information is required from applicants, decisions may be delayed. ADHS advises all applicants to ensure only complete applications are submitted to minimize any delay in decisions.

To determine if a site is designated as a Health Professional Shortage Area (HPSA) or Medically Underserved Area/Population (MUA/P), enter the complete street address of the location on the Shortage Designation Advisor website.

Requests for site eligibility determination must be made in writing and submitted to the program manager or specialist as noted on the Contact Us webpage.

Sliding discount-to-fee schedules must be based on current Federal Poverty Guidelines and adhere to A.A.C. R9-1-504 sliding fee schedule submission and content.

Sample Sliding Discount-to-Fee Schedule            [PDF]

Sample Notice of Discount                                        [PDF]

The Department of Health and Human Services also has a J-1 waiver program available. For more information visit their website at: http://www.globalhealth.gov/exchangevisitorprogram/
 

   
    The following links are in PDF format.  To download, Acrobat Reader™ is required.  
       
Applications:  2009 J-1 Visa Waiver Program Info:  
  
2009 Primary Care Physicians: [PDF]
2009 Specialists: [PDF]
2009 Scoring Criteria: [PDF]
2009 Contract Guidelines: [PDF]
   

2009 Provider Application:

[PDF]
    2009 Service Site Application: [PDF]
   
The Arizona Department of Health Services requests that physicians who have received support for their J-1 Visa Waiver submit an Encounter Form quarterly. 
  
UPDATED: J-1 Visa Waiver Encounter Form [PDF]

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