Immigration questionnaire Form 2023

Immigration questionnaire Form: What You Should Know

If you are not able to attend the first appointment, please contact us as soon as possible. Please be sure you have checked the box next to the “How do I prepare my signature” section. You may sign your name(s) on the first page only. Please be sure you have checked the box next to the “How do I prepare my signature” section. Please use this form to request a letter of clearance for the following types of aliens: (a) A spouse of the sponsor, child/child(men) under the age of 18, or child of the sponsor and/or spouse for whom the sponsoring spouse is the legal or natural parent unless they are: a) United States citizens, b) naturalized citizens, c) legal residents of a foreign country, and d) other visa-exempt foreigners who are not visa-restricted citizens. The spouse, children, or children of the sponsor must present an original and two (2) attestation statements from a licensed health care professional(s) from an accredited health insurance company to verify that the health, dental and vision plan are in full effect. For children, the attestation statement must be dated within 10 days of the interview date and must include names, address, and telephone number of the health insurance company(s) for which the attestation statements were made. For more information concerning attestation statements, visit HHS Direct. If the health care provider(s) is not available, or if you have questions regarding the attestation statements, please direct them to HHS-OIG. Please use this form to request a letter of clearance for the following types of aliens: (a) A spouse of the sponsor, child(men) under the age of 18, or child of the sponsor and/or spouse for whom the sponsoring spouse is the legal or natural parent unless they are: a) United States citizens, b) naturalized citizens, c) legal residents of a foreign country, and d) other visa-exempt foreigners who are not visa-restricted citizens. The spouse, children, or children of the sponsor must present an original and two (2) attestation statements from a licensed health care professional(s) from an accredited health insurance company to verify that the health, dental and vision plan are in full effect. For more information concerning attestation statements, visit HHS Direct.

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