SEMILLA

SEMILLA CASAS Program Health Screening

Download and complete these forms to submit with your CASAS program application.

Each participant must complete and sign a health screening form to submit with their program registration.

Health Screening - Part 1 Health Screening - Part 2

Health Screening - Part 1

Less than 30 Day CASAS Program

ALL participants who participate in a SEMILLA CASAS Program in Guatemala must complete Part 1 of the Health Screening Form. This form must be signed and returned to the SEMILLA CASAS Program Director before the participant is approved to participate in a SEMILLA CASAS Program. This confidential information will be used in case of an emergency.

SEMILLA Health Screening Form – Part 1 (PDF)

Health Screening - Part 2

More than 30 Day CASAS Program

All participants who plan to participate in a SEMILLA CASAS program for more than 30 days must be medically cleared to participate in SEMILLA CASAS Programs for an extended period of time. Copies of this form are to be retained by both the healthcare professional and the participant as a confidential medical record.

SEMILLA Health Screening Form – Part 2 (PDF)