Medical Deployment Packet for all USAP participants.
U.S. Antarctic Program - Travel & Deployment Section United States Antarctic Program United States Antarctic Program Logo National Science Foundation Logo
 

ASC Medical Department processes all medical paperwork for potential participants, and this web page contains only Medical paperwork.

disclaimer DISCLAIMER
USAP medical and travel qualification forms are only to be completed and submitted by individuals who have received valid offer letters of employment and/or official National Science Foundation approval for deployment to Antarctica. Submissions without valid offers or approvals do not constitute an obligation on the part of the USAP for employment or deployment.

The tests that are required for individual participants are included in the customized deployment packet provided for the individual by UTMB. Check the Medical and Dental Checklist for Deployment Clearance to Antarctica included in the provided packet (via email), and be sure to make your appointments as soon as possible. Bring the checklist with you to every appointment.

The prior NSF Medical forms have been replaced with an electronic version of the forms.  Please contact UTMB at 855.300.9704 or polmedpq@utmb.edu to obtain a copy of the form.

Travel Paperwork
ASC Personnel, Grantees, and Technical Events have additional travel paperwork that needs to be completed separately from your medical paperwork.

Explanation:
ASC Personnel
Grantees and T-Events

NOTE: The Medical Deployment Packet contains all the required forms for the medical prequalification process. You need to complete, print, and return the completed packet to UTMB. Mail or fax the printed packet to the following:

UTMB Polar Medical Operations
Levin Hall, 5th Floor, Suite 5.527, Route 1004
301 University Blvd
Galveston TX 77555-1004

Fax: 409.772.3600

You may print the Medical FAQ's Link to PDF file document as an aid to assist you in the PQ process.

You must mail (NO email) or fax all completed medical forms to ASC eight weeks prior to your deployment.

Do not submit completed medical forms or other documents that contain personally identifiable information via email. Explanation

 

Paperwork That Medical Professionals Fill Out and You Send Back to ASC Medical/UTMB
Paperwork That You Need to Fill Out and Send Back to ASC Medical/UTMB
Paperwork That You Need to Read and Keep for Reference
Health Status and Name Changes
ASC Medical Staff Contacts

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Items Included in your Medical Deployment Packet That Medical Professionals Fill Out and You Send Back to UTMB

Completed by Your Doctor:

  • Polar Physical Examination—Antarctica
  • Required Laboratory Tests
  • Any additional testing as indicated on checklist

NOTE: Be sure to provide your doctor with the letter addressed Dear Doctor

Completed by Your Dentist:

  • Polar Dental Examination—Antarctica
  • The original dental X-rays

NOTE: Be sure to provide your dentist with the letter addressed Dear Dentist

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Items Included in your Medical Deployment Packet That You Fill Out and Send Back to UTMB
  • Personal Information Form
  • Medical History
  • Medical Screening for Blood-borne Pathogens/Consent for HIV Antibody Blood Test

Important Notice to Those Signing the Medical Screening for Blood-borne Pathogens/HIV Consent Form

  • Medical Risks for NSF-Sponsored Personnel Traveling to Antarctica
  • Authorization for Treatment of Field-Team Member/Participant Under the Age of 18 Years
  • Important Notice Regarding Personal Conduct
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Paperwork That You Need to Read and Keep for Reference
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Health Status and Name Changes

You are required to report any changes in your health status that occur after your physical examination, as well as name changes (for name changes, be sure to send your former and new names). You can send changes to the address or fax number above.

If you need medical care while in New Zealand or Chile, please use the following contact numbers:

PAENZ Medical Coordinator:  

Leeann Stringer

720.568.2886
DAMCO office:  
Santiago  

Carlos Maturana

569-9885-7884
Punta Arenas  

Gonzalo Aviles

569-7548-3942
Secondary contact  

Joe Salinas

569-7988-4013

NOTE: Be prepared to pay for services at your appointment.

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Curator: Michael Savage, Antarctic Support Contract   |   NSF Official: Polly Penhale/Paul Sheppard, Division of Polar Programs