Request a Referral For a Medical Exam

If you are an attorney and would like to request a forensic medical, psychological, or gynecological examination for a client seeking asylum, please submit the information below. We will review your request in a timely manner and let you know if we are able to take your case. Accepted cases will then be registered for tracking with Physicians for Human Rights. Please note that our program also serves an educational purpose: both you and your client must be willing to work with students in conjunction with our volunteer faculty.

Attorney name *
Attorney name
Final deadline for medical report *
Final deadline for medical report
Type of examination *