Visitor Submission Instructions

	Form Field(s)	Instructions
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1	This sheet provides detailed instructions for entering visit requests. For questions, please contact nihvisitrequest@mail.nih.gov. All Form Fields marked with an * below are mandatory	(OMB#: 0925-0740, Exp: 9/30/2025)
2	Privacy Statement *	Click on the link provided to read the privacy statement in its entirety. After reading the statement, read the consent statement on the website and click on the checkbox.
3	Form Submitted by*	Select one of the options from the drop-down menu to indicate who is submitting the visit request.
4	Visitor Name (First) *	Enter legal first name (e.g., Matthew). Do not enter nicknames or abbreviated names (e.g., Matt). The first name must exactly match the name used on the identification card that will be presented at the time of the visit. If an individual does not have a legal first name, enter "No First Name."
5	Visitor Name (Middle)	If applicable, enter legal middle name (e.g., Samantha). Do not enter nicknames for abbreviated names (e.g., Sam). The middle name must exactly match the name used on the identification card that will be presented at the time of the visit. If the visitor does not have a middle name, leave this field blank.
6	Visitor Name (Last) *	Enter legal last name. Do not provide former legal names (if applicable). The last name must exactly match the name used on the identification card that will be presented at the time of the visit.
7	Visitor Other Name(s) Used	Enter any other names used (i.e., maiden name, former names, aliases, nicknames, etc.). Please enter other names used in FIRST MIDDLE LAST format (e.g., Jonathan Andrew Miller). If no other names are used, leave this field blank.
8	Visitor Organization / Employer *	Enter the current organization or employer the visitor is representing. Enter “None” or “Not Applicable” if the visitor is not employed or representing any specific organization. Multiple employers or organizations can be provided if appropriate.
9	Visitor Phone Number	Provide a valid phone number to contact the visitor. If the visitor cannot be contacted via phone, leave this field blank.
10	Visitor Email*	Provide a valid email address to contact the visitor. If the visitor cannot be contacted via email, enter “none” in this field.
11	Visitor Date of Birth *	Click on the blue box to select the Visitor Date of Birth. Or manually enter the date in MM/DD/YYYY format.
12	Visitor Place of Birth (Country) *	Select the country where the visitor was born from the drop-down list (e.g., Spain).
13	Visitor Place of Birth (City) *	Enter the city where the visitor was born (e.g., Madrid).
14	Visitor Country(ies) of Citizenship *	Select all countries from the drop-down list where the visitor is currently considered a citizen (e.g., France, India, etc.)
15	Passport Type *	Select a Passport Type from the options provided on the form. If you are not sure what to select, choose the “Unspecified” option.
16	Passport Number *	Enter the passport book number (located in the upper right-hand corner near passport photo and other identifying information)
17	Passport Issuing County *	Select the country that issued the passport from the list provided. If the country is not listed, select the “Other” option.
18	Passport Issuance Date *	Click on the blue box to select the passport issuance date. Or manually enter the date in MM/DD/YYYY format.
19	Passport Expiration Date *	Click on the blue box to select the passport expiration date. Or manually enter the date in MM/DD/YYYY format.
20	Visa Type*	Select the Visa Type from the options provided on the form. If you are not sure of what to select, choose the “Other” option. If the visitor does not have a visa, select N/A.
21	Visa Number*	Enter the full visa number. If the visitor does not have a visa, enter N/A.
22	Visa Issuance Date*	Click on the blue box to select the visa issuance date. Or manually enter the date in MM/DD/YYYY format. If the visitor does not have a visa, enter today’s date.
23	Visa Expiration Date*	Click on the blue box to select the visa expiration date. Or manually enter the date in MM/DD/YYYY format. If the visitor does not have a visa, enter today’s date.
24	Purpose of the Visit *	Enter the purpose of this visit. Please provide sufficient detail as to the nature of the visit. For example: Do not simply say “meeting” but indicate “meeting with Dr. Smith from NCI.” Do not simply say “work” but say “construction work on Building 10.” Do not simply say “conference” but say “attending NIH Grants Conference.”
25	NIH Facility Location(s) *	Select all NIH Facility Location(s) being visited from the drop-down list provided. If the location is not listed, select the “Other” option.
26	NIH Building Locations *	Select all NIH Building Location(s) being visited from the drop-down list provided. If the location is not listed, select the "Other" option.
27	NIH Room Numbers *	Enter the NIH Room Number(s) that will be visited.
28	Lab(s)	Enter the NIH Lab(s) that will be visited. If none, leave this field blank.
29	Visit Start Date *	Click on the blue box to select the Visit Start Date. Or manually enter the date in MM/DD/YYYY format.
30	Visit End Date *	Click on the blue box to select the Visit End Date. Or manually enter the date in MM/DD/YYYY format.
31	NIH Host Institute *	Select the Institute of the NIH Host from the drop-down list provided.
32	NIH Host Name (First) *	Enter the first name of the NIH Host. Abbreviated names are acceptable (e.g., Matt instead of Matthew).
33	NIH Host Name (Last) *	Enter the last name of the NIH Host. Maiden names and/or aliases are not acceptable.
34	NIH Host Phone Number	Provide a valid phone number to contact the NIH Host. If the NIH Host cannot be contacted via phone, leave this field blank.
35	NIH Host Email Address *	Provide the NIH email address for the Host. This cannot be a non-NIH email address (e.g., Gmail).
36	NIH Escort Name (First)	Enter the first name of the NIH Escort. Abbreviated names are acceptable (e.g., Matt instead of Matthew). One person may escort up to a maximum of five (5) visitors.
37	NIH Escort Name (Last)	Enter the last name of the NIH Escort. Maiden names and/or aliases are not acceptable. One person may escort up to a maximum of five (5) visitors.
38	NIH Escort Phone	Provide a valid phone number to contact the NIH Escort. If the NIH Escort cannot be contacted via phone, leave this field blank. One person may escort up to a maximum of five (5) visitors.
39	NIH Escort Email	Provide the NIH email address for the Escort. This cannot be a non-NIH email address (e.g., Gmail). One person may escort up to a maximum of five (5) visitors.
40	File Attachments *	A photocopy of the visitor’s passport data/bio page and photocopy of the passport visa page (only data/bio page required if from a Visa Waiver Program country). Photocopies are uploaded by clicking on the “Upload” button. To upload multiple attachments click on the “Upload” button for each additional attachment prior to clicking submit.
41	Form Submission	Upon providing the required information, the person completing this form should do the following: • Read the Submission statement attesting the information provided is true and accurate to the best of their knowledge. • Click on the box to receive a copy of the submitted information (if desired) • Check the “I’m not a robot” box • Click on Submit
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