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Primary Care Office (PCO) – the person/organization responsible for J-1 waivers and HPSA designations at the state


You can find a list of PCOs here:

An additional resource for J-1 contacts:

Questions to ask the PCO

• What do you typically use your ‘flex’ positions for?

• Do you fill your slots? If so, how fast?

• What are the state specific requirements?

• Are there any state-specific application (or other) fees? What are they for, and how much are they?

• Are there any other agencies in this state that give waivers? For example, Delta Regional Authority, Appalachian

Regional Commission, Department of Health and Human Services.

• Where can I find my HPSA scores?

• Does the candidate need a license prior to the J-1 process / where does licensure fit into the J-1 process in our



Ultimately, it is you the employer and not the IMG that applies for the J-1 waiver and sponsors the IMG for a change

into H-1B status.

As an employer, you have the legal obligation to pay H-1B attorneys fees and filing fee costs – conversely, the IMG

cannot pay for H-1B fees or costs.

Make sure you are aware of your immigration obligations.

Facilities can ask during interview process: “Are you legally authorized to work in the United States?” and “Do you

need visa sponsorship?”

Facilities can ask the following follow-up questions: “What is your current status?”, “What visa sponsorship is

needed?”, and “How much time do you have left in your current status.

Job Seeker

You can expect candidates to want answers to the following questions:

• Who in the organization will take the lead for immigration purposes?

• What has been the employer’s experience in the past with J-1 waivers?

• What attorneys has the employer used in the past?

• What is the culture in the employer?

• What assistance will you receive in integrating into the community?

“Players” Involved in the J-1 Visa Waiver Process