Per the requirement at 77 Illlinois Administrative Code 591.140(a), you are being contacted to verify informtion regarding your J-1 waiver in Illinois.  Please go to the bottom of this page, check the box and click the "SUBMIT PHYSICIAN REPORT" button.  After you click the button, you will be directed to another page that will allow you to enter information to complete the report.  If you work at more than one medical facility, you will need to complete a report for each facility.

The time frame for reporting data on this report is July 1, 2023 through December 31, 2023.

When you submit the report, you are attesting that the informaiton you provide is true and correct.  Providing false or misleading information could result in licensure action and possible revocation of your J-1 waiver.

Before you submit the report, review all of the information for accuracy.

After you submit the report, you will be directed to another page confirming receipt.  If you are not directed to this page, it means your report was not received.  Please contact program staff at dph.j1waiver@illinois.gov if you experience difficulty accessing this page.

If you submit the report and need to make changes, contact program staff.  Do not submit another report.

Please contact our office should you have any questions.

Contact Information

Illinois Department of Public Health
Center for Rural Health
J-1 Visa Waiver Program
535 West Jefferson Street, Ground Floor
Springfield, IL 62761-0001

Phone:  217-782-1624
fax:  217-782-2547

e-mail:  dph.j1waiver@illinois.gov