I think many of the members on this site completed the required paperwork in a "dry-run" method. You can find copies of the p-4 paperwork here on this site and fill in the blanks, so that your partner can be prepared to complete the forms once they arrive, by copying from one to another. While many members have not had a problem using and submitting the p-4 forms they found online, there may be an anal VO or clerk that wants you to use only those forms supplied by their offices. In either case, you should have no problem. Just make sure that you're prepared to get the medical done at least two days before the interview, and no later than the day before. You may want to have her call the consulate herself and make the request. They may make arrangements for her to get there a few days before the interview to pick up the paperwork. Have you been able to verify that the address they have on register for her matches her actual address. Has she received previous mailings, e.g., the P3? If so, I wouldn't fret too much about it, as they should be able to reprint that information and make it available for pickup; but again, someone, either you are her needs to nail that down via telephone... good luck... She needs the P4 letter to do the medical exam.. depending on where you were hoping to do the medical, you probably want to get this letter sooner than later.. I agree... P4 or some sort of prove from GZ that she is legit to do the exam and interview... They should have some way to cover it...