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1. Complete all information on the Missionary Recommendation form. |
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Have the physician complete the Physician's Health Evaluation of |
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Type if possible, or print neatly in black ink. Write dates in day, month, |
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Missionary Candidate form and mail it and the Personal Health History |
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year format (15 Dec 2001). |
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of Missionary Candidate form to your bishop or branch president. |
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2. Complete the Education and Service of Missionary Candidate form. Fill |
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Where mail is unreliable, personally retrieve the forms. |
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out the Personal Health History of Missionary Candidate form |
7. |
Begin the hepatitis A and B immunizations and boosters for diphtheria, |
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completely, honestly, and accurately before your medical examination. |
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tetanus, measles, and mumps immediately. You will receive additional |
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3. Sign the “Authorization to Release Information” section on the |
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immunization information with your mission call. |
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Physician's Health Evaluation of Missionary Candidate form. |
8. |
Obtain a thorough dental examination. Begin early. Sign the |
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4. If you have had any major illness, major operation, major injury, |
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“Authorization to Release Information” section on the Dental Evaluation |
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for Missionary Candidate form, and give the form to the dentist along |
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prolonged treatment, or hospitalization, obtain a statement from the |
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with a stamped envelope addressed to your bishop or branch |
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professional who treated you, if possible, to explain the nature of the |
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president. Have the dentist fill out the form and mail it to your bishop or |
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problem and its current status. It is important that you provide complete |
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branch president. Where mail is unreliable, personally retrieve the |
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information about your physical condition. For example, it is not enough |
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forms. |
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to say that you had a knee injury; you must also state which knee was |
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injured and explain whether there are any persistent problems with the |
9. |
Have all dental work, including orthodontic work, completed before |
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knee. |
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submitting the missionary recommendation packet to your bishop or |
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5. The Physician's Health Evaluation of Missionary Candidate form must |
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branch president. |
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be signed by a medical doctor (MD) or doctor of osteopathy (DO). If the |
10. |
You are expected to be physically and emotionally capable of working |
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examination is done by a physician assistant (PA) or nurse practitioner |
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several hours a day. For young missionaries, this means walking |
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(NP), the supervising physician must verify the findings and review and |
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several miles a day six days a week. If there are reasons why this |
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countersign the form. An examination by any other practitioner is not |
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might not be possible, please discuss them with your bishop or branch |
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acceptable. |
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president. |
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6. Give the following forms to the physician along with a stamped envelope |
11. |
Before entering the MTC, correct any problems such as plantar warts, |
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addressed to your bishop or branch president: |
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flat feet, chronic headaches, inguinal hernias, and so on. Stabilize and |
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The completed Personal Health History of Missionary Candidate |
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understand the treatment for chronic problems such as asthma, |
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diabetes, seizures, emotional disorders, irritable bowel, endometriosis, |
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form. |
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and so on. |
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The Instructions for Physicians Evaluating Missionary Candidates. |
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The Physician's Health Evaluation of Missionary Candidate form. |
12. |
If you are taking prescribed medication for any chronic problem, |
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medical or emotional, do not stop taking it unless your physician |
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advises you to do so. Please list on the Personal Health History of |
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Missionary Candidate form all medications you are currently taking. |
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13. |
Complete all appropriate sections of the Personal Insurance |
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Information of Missionary Candidate form. |
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Instructions for Parents of Young Missionaries |
5. Pay particular attention to item 11 above. This will help avoid unnecessary |
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1. Review the completed forms, and add any pertinent information. |
problems and expenses in the MTC or the mission field. |
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2. Please make sure that the instructions under item 3 above are carried out |
6. If you have private insurance coverage for your son or daughter, do not |
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discontinue it. Please note it on the Personal Insurance Information of |
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and that clarifying statements are submitted with the Personal Health |
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Missionary Candidate form with pertinent data. |
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History of Missionary Candidate form. Failure to do so may delay the |
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mission call unnecessarily. |
7. During the mission, a missionary’s family must bear the costs of caring for |
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preexisting medical conditions. A preexisting condition is any chronic, |
medications. Problems may arise when missionary candidates stop taking treatment within two years before the missionary enters the mission field, medication because they believe that being on medication might affect the