NEW - Application Submission Procedure, Effective August 8, 2017
The Department of Public Health will only accept application material that is hand delivered. All hand delivered applications will only be accepted in the first floor lobby area at the Connecticut Department of Public Health beginning at 8:00 a.m. on Monday, October 2, 2017. The Department’s address is as follows:
Connecticut Department of Public Health
410 Capitol Ave.
Hartford, CT 06134
410 Capitol Ave.
Hartford, CT 06134
Please do not enter the building at any other entrance other than the first floor lobby area entrance from Capitol Avenue. The first floor lobby area off of Capitol Avenue is open to the public at 7:00 a.m.
There will be a DPH staff person with a numbered sign in sheet in the first floor lobby area. Individuals delivering applications will be requested to enter their information onto the sign in sheet and will be handed a corresponding card with the number assigned. Department staff will meet with individuals in the order that the individual signed in. Please note that it is possible that an individual may be dropping off multiple applications. As a result, an individual may be signed in within the first 30 but the applications the individual is delivering may not be within the first 30 received.
When Department staff meet with an individual and receive an application(s), Department staff will assign a number to the application(s) being delivered in the order that it is received. Applications will not be reviewed for completeness at the time the application is hand delivered.
The Department will review the applications in the order that they are received. If an applicant is not licensed or an application is incomplete at the time of the Department’s review, the application will be skipped and the next application will be reviewed. Once 30 complete applications have been identified in the order received, those 30 will be referred to the United States Department of State recommending a waiver of the two year home residency requirement.
Applications received by U.S. Mail, Federal Express, United Parcel Service or other similar service or received in any fashion other than as specified above will not be accepted or considered and will be returned to sender.
The Connecticut Department of Public Health participates in the J-1 Visa waiver program, also known as the “Conrad State 30” program. Under this program the Department may recommend up to 30 applications per federal fiscal year for waiver of the two-year home residency requirement pursuant to Section 220 of Public Law 103-416 and the Regulations of Connecticut State Agencies. The Connecticut licensed physician must commit to provide medical services in a setting located in an underserved area for 40 hours per week for at least 3 years.
Each application submitted prior to April 1 of each fiscal year shall be taken in order of submission if deemed complete, thereafter if the total number of applications has not reached 30, applications shall be considered in order of submission and may include applications for a physician or surgeon who (1) agrees to practice medicine in a setting that is located in a geographic area designated by the United States Secretary of Health and Human Services as having a shortage of health care professionals; or (2) agrees to practice medicine in a setting that serves patients who reside in one or more geographic areas designated by the Secretary as having a shortage of health care professionals without regard to whether such facility is located within such designated area.
5 of the 30 requests may be for physicians who will provide medical services in a setting not located in a designated area but serves patients who live within a designated health care professional shortage area.
Please select a link below for documentation requirements for applying for the waiver: