You can go to the following link to start the EC application process, which can be done initially online.
http://www.britainusa.com/visas/article ... 8&L1=41000
The link also specifies the documents you will need to supply and what fees you will need to pay (about $450). To be on the safe side, it seems that a number of EC applicants from the US supply additional documentation of their eligibility for HSMP: apart from the approval letter, they tend also to supply some, but not all, of the evidence provided in the initial application (although some applicants do provide all of it). Application through the NYC consulate takes a week or less, door-to-door. You will not need to provide evidence of medical testing (unless they specifically request it, of course).
Here's what I used for my EC application in June 2007:
- passports (current and former)
- HSMP approval letter
- printed application form and photograph
- my letter explaining the following:
a. To demonstrate HSMP eligibility
- 2006 tax returns (W2, 1099) for income points (my claimed earnings period)
- transcript, academic certificate, dean's letter on English language instruction, for education points
b. To demonstrate lack of need for recourse to public funds
- current account statements (three months)
- stock and retirement portfolio statements (three months)
- short budget showing expected expenditure for 4-5 months
c. To demonstrate employability
- printouts of selected job openings for which I'd be eligible to apply
- cv
Hope that helps
AG