Waiver Process Step-by-Step

Find HPSA-designated employer, negotiate contract (no non-compete, 40 hrs/week, 3-year commitment), obtain state medical license. Hire immigration attorney specializing in physician immigration.

This is filed FIRST. You need the DOS case number before submitting to your state. Complete online, mail $120 fee + copies of ALL DS-2019 forms ever issued to you. Case number is assigned immediately upon filing.

Employer prepares: Letter of Need, evidence of failed US recruitment (6+ months), community support letters, HPSA documentation. You provide: J-1 docs, diplomas, license, CV.

State DOH evaluates application. If approved, state forwards a recommendation letter to the DOS Waiver Review Division. Fast states (WY, WV): 2-3 weeks. Slow states (CA, NY): 8-12+ weeks.

Department of State reviews the state's recommendation and your DS-3035 application. If favorable, DOS sends a 'No Objection' recommendation to USCIS. Cannot be expedited. $120 DOS fee.

USCIS receives DOS favorable recommendation and issues I-797 Waiver Approval Notice. Note: I-612 form is NOT required for Conrad 30 — USCIS initiates this internally. The I-797 includes an addendum specifying your waiver terms.

Employer files I-129 H-1B petition with USCIS immediately after waiver approval. Conrad waiver physicians are H-1B cap-exempt — no lottery required, can file year-round. STRONGLY use premium processing ($2,965) for 15-day guarantee. Regular processing: 3-6 months. DO NOT travel outside US while change of status is pending.

I-797A is your proof of H-1B status. Your new I-94 authorizes work for the sponsoring employer. If you need to travel abroad later, you'll need a visa stamp at a US consulate before reentry.

Full-time (40+ hrs/week) at the designated HPSA facility for exactly 3 years. File your I-140 green card petition during this period (ideally year 1-2).