Travel Forms

Start planning with these important forms.  Links below.

Liability waiver (PDF)

Student Application

International Rotation

IMOC Registration

Scedule and Payments

To learn about our outreach program and locations, check out the Countries and Schedules of Trips guide.

To make payments for upcoming events, please click here.

Want to know more?

If you would like to learn more about the COM International Medical Outreach Programs, please contact nsuimoc@gmail.com

ECUADOR (MAY 2017)

Medical outreach to Ecuador

Dates & Destination: May 6 – 14, 2017 – Quito, Ecuador

Outreach Program Leader: Elaine Wallace, DO, MS, MS, MS/Dean

Estimated Cost: Approximately $1400 which includes airline, all transportation in Florida and Ecuador, eco-lodging and food. Some opportunities for birding and/or hiking are usually available. $600 deposit with completed application due by 3/30/2017. This $600 deposit is 100% refundable up to the date of final payment. Final payment due date is to be determined.

The Ecuador Medical Outreach Program provides free medical care to the underserved population in rural areas of Ecuador. Students, faculty, staff, physicians and volunteers from the community all give of their time and talent to provide medical care that would otherwise not be available. The goal is to provide quality care and build sustainable relationships with the opportunity to teach and practice. This unique opportunity offers the chance to serve medically needy populations in beautiful isolated areas of Ecuador. The areas served are with the support of the local residents and range from beautiful mountains under 9,000 feet to the cloud forests and eventually down to the rain forest with all of the areas abundant with beautiful birds and foliage.

The local leader is a veterinarian and an environmentalist who not only works with us in arranging our sites but also shows us ways to better see the beautiful environment in which we will be providing the health care services. The Ecuador medical outreach trip allows all participants to develop relationships with community residents, compile medical histories and treat a variety of illnesses.

For additional information or questions please contact: Evelyn Martinez at em1036@nova.eduor at 954-262-1897.

JAMAICA (JUNE 2017)                 

Outreach Program Leader: Dr. Paula Anderson-Worts

Dates: June 3 -12, 2017

Cost: $1,415 estimated including roundtrip airfare/travel from Fort Lauderdale to Kingston, transport, accommodations, and about 70% of meals.

Application deadline: Currently accepting applications

The Jamaica Medical Outreach Program provides free medical care to the underserved. Students, faculty, staff, physicians and other participants in the private sector, volunteer their time and talents to provide medical services that would otherwise be difficult for patients to access. The goal is to provide quality care and build loving and trusting relationships with the opportunity to practice and teach. The Jamaica outreach sends volunteers to rural areas of Jamaica to participate in a humanitarian effort to provide health care services to the community. The volunteer medical group includes physicians and students from various disciplines such as: dentistry, occupational therapy, public health, pharmacy, optometry, and physical therapy. The outreach program to Jamaica allows participants to develop relationships with community residents, while providing greatly need medical care. During the medical outreach, participants will fly into Kingston and may spend their non-service days of the trip visiting surrounding sites.

If you would like to learn more about Medical Outreach to Jamaica, please contact Dr. Paula Anderson-Worts at (954) 262-1463.

Jamaica Application Forms All forms for Jamaica (below) must be sent to Dr. Anderson-Worts.