The Beijing Center

The Beijing Center for Chinese Studies Student Health Self-Disclosure Form

 
First Name:
 
Last Name:
 
Indicate Program(s):
 

  To be completed by the student: Please complete and sign this form.

 
Gender
   
 
Do you hold religious beliefs that might impact the provision of emergency medical treatment while you are abroad?
   
 
If yes, give details:
 
Are you required to wear a health emergency bracelet?
 
 
 
If yes, for what condition?
 
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