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E-9, E-10, H-2 Health & Mentality Statement

The document is a health and mentality statement form for E-9, E-10, and H-2 visa applicants, requiring accurate and truthful information to avoid visa denial or deportation. It includes questions about infectious diseases, substance abuse, mental health treatment, and serious illnesses. Applicants must also register as foreigners within 90 days of arrival in Korea and submit a medical examination certificate.

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7 views1 page

E-9, E-10, H-2 Health & Mentality Statement

The document is a health and mentality statement form for E-9, E-10, and H-2 visa applicants, requiring accurate and truthful information to avoid visa denial or deportation. It includes questions about infectious diseases, substance abuse, mental health treatment, and serious illnesses. Applicants must also register as foreigners within 90 days of arrival in Korea and submit a medical examination certificate.

Uploaded by

maryroserusiana08
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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E-9 / E-10 / H-2 Visa Applicants'

Health & Mentality Statement


This form is to check the E-9, E-10 and H-2 visa applicants' health and mentality.
An applicant must fill out this form accurately and truthfully. An applicant will be faced
with consequences such as denial of visa application, cancellation of visa approval, and/or
deportation if the details on the statement are not true or missed out.

1) Full Name (As in passport) 2) Date of Birth

3) Nationality 4) Sex 5) Passport Number

6) Have you ever had any infectious diseases that threatened the public health before?
Yes □ (Name of Disease : Syphilis, Viral hepatitis type B, Tuberculosis) No □

7) Have you taken any banned substances(drugs) or been addicted to alcohol in the last 5 years?
Yes □ (Name of Drug : ) No □

8) Have you ever received medical treatment for mental, emotional, or neurotic disorders?
Yes □ (Name of Disorder : ) No □

9) Have you had any serious diseases or injuries in the last 5 years?
Yes □ (Name and recent state : ) No □

NOTE : You must be registered as a foreigner at the immigration office or branch


office under the jurisdiction of your residence within 90 days after arriving in Korea
if you wish to stay longer than 90 days. At the time of registration, you must submit
your medical examination certificate obtained from the designated hospitals by the
Korean government. Besides, you must complete the basic training program on law
and order set by the government for alien registration.
Date (Y/M/D) :

Applicant : (Signature)

TO : Korean Ambassador to Embassy of the Republic of Korea in the Philippines

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