HEALTH CERTIFICATE
FOR EXCHANGE STUDENTS FROM COUNTRIES
WITH A DESIGNATED RISK OF TUBERCULOSIS
(IF REQUIRED, SEE BELOW!)
Only required, if student
-was born in a country where the incidence of tuberculosis is very high(‘erittäin korkea’ in Finnish)
-has lived at least 12 months or has worked for at least 3 months in a country where the prevalence of tuberculosis is high(‘korkea’ in Finnish)
-has treated any infectious tuberculosis patient without a respirator or has been in close contact with a fetal tuberculosis patient
If required, this health certificate must be providedas a scan (pdf) during the application to MoveON or afterwards to . The health certificate must be filled in and duly signed by ahealth care professionalin the student’s home country before the exchange!
Name of student (forename and surname)
Home country of student
Phone number of student (international format) / E-mail address of student
Date of birth of student (DD/MM/YYYY)
DD/MM/YYYY
Information on TB RISK & examinations (only if required)
Chest radiograph (X-ray) or pulmonary report, max 6 months old!
The radiograph does not have to be provided – it is sufficient that the health care professional states the result in the respective text field
/ Date (DD/MM/YYYY):
DD/MM/YYYY
Result (to be stated): / Only required, if student
- was born in a country where the incidence of tuberculosis is very high (‘erittäin korkea’ in Finnish)
- has lived at least 12 months or has worked for at least 3 months in a country where the prevalence of tuberculosis is high (‘korkea’ in Finnish)
- has treated any infectious tuberculosis patient without a respirator or has been in close contact with a tuberculosis patient
Statmement of Health Care Professional
I hereby certify that the information provided about the student above is correct.
Health care professional’s name in block letters, and signature
Place / Date
DD/MM/YYYY
Oulu UNIVERSITY OF APPLIED SCIENCES, INTERNATIONAL SERVICES:: oamk.fi
CITY OF Oulu, STUDENT HEALTH CARE::