Independent Research Abroad

Exit this survey 

1. Name

2. Funding Source:

3. Name of the faculty or department supervisor for this grant?

4. City and Country in which you will conduct research:

5. During what term will you be conducting reserch?

6. What immunizations does the Centers for Disease Control recommend for you city/country?

7. What is the address and phone number of the nearest hospital/medical center? (If you will be in more than one location, list the nearest hospitals for each location.)

8. What is the address and telephone number of the nearest US embassy or consulate? (If you are not a US citizen, give this information for your country's embassy)

9. What is the name of your health insurance provider?

10. Does your health insurance provider offer services for travelers abroad?

11. If yes, how do you access the travel benefits while abroad?

12. What is the address and telephone number of the nearest US Embassy American Citizens Services?

13. Name the returned student(s) from your country to whom you spoke to prepare for your time abroad.