Deceleration Request Form - To be completed only when deceleration to another class is not a result of a Leave of Absence. Must be submitted to CSPE.
Leave of Absence Request Form - Must be submitted to CSPE for approval. Must include letter explaining the leave, pertinent information regarding your actions while on leave and any pertinent steps you will take to re-enter the curriculum.
Global Health Request for Funding Assistance - Global Health is accepting funding applications. This form must be submitted for approval 45 days prior to travel. Please contact Cristina Beraun if you have questions.
Phase III Credit Request Form- Must be submitted to CSPE for approval prior to beginning any away rotation. Requests must be received by the Office of Medical Student Affairs 45 days before the start of the requested rotation. A course description, from website or catalog, must accompany the request form. Students must have the appropriate UNM department chair sign the request form.
Sub-Internship or ICU Credit Request Form - Students may request Sub-Internship or ICU Credit for an away rotation as long as the course meets the appropriate requirements. This Credit Request form must be completed and signed by the faculty advisor at the external location and submitted along with the Phase III Credit Request Form to CSPE. Retroactive requests for Sub-Internship or ICU Credit will not be considered.
Grade Evaluation Form - This form is used to evaluate and grade a student's performance for Phase III rotations. It must be filled out by the attending physician and returned to the Office of Medical Student Affairs.
Request for Exception to the Rural Requirement for PIE - This for is used to request an exception to the rural requirement for PIE. This form is reviewed by CSPE. Approval is not guaranteed.
PRIME Definitions - Defines the PRIME system of evaluation.
ERAS Cover Sheet for Letters of Recommendation - ERAS form provided to letter writers for Letters of Recommendation for the ERAS/NRMP Matching process. Students must complete the form and provide it to each letter writer. The letter writer then submits the form with their letter of recommendation to the Office of Medical Student Affairs.
Request for Letter of Recommendation from Dean - You must complete this form and submit it to the Office of Medical Student Affairs, along with the supporting documentation, if you would like a letter of recommendation from the Associate Dean of Students.
Request for Information from Medical Student Affairs - This form is used to request information from Student Affairs. If you have questions, please contact the office.
Faculty Request for New Phase III Clerkship - This form is used for faculty and staff to begin the process of creating a new Phase III Clerkship.
Required Immunization Form - This form must be filled out by the UNM SHAC Immunization Clinic.
Match Consent Form - All graduating medical students must sign this form giving consent for their name, degree program, match information, research title, and awards to be released by UNM School of Medicine.
Check List - All graduating medical students must complete a variety of tasks in order to ensure a seamless transition from medical school. This checklist must be submitted to the Office of Medical Student Affairs along with applicable items listed therein
Intent to Graduate Form - All graduating medical students must complete this form and turn it in to the Office of Medical Student Affairs
Guest Hooder Form - All graduating medical students who are participating in the Convocation ceremony must complete this form and turn in to the Office of Medical Student Affairs
Student Privacy
Waiver - All graduating medical students must sign this
form giving consent for their name to be published in the programs for the
University Commencement Ceremony and the School of Medicine Convocation
Ceremony. Please contact Cristina
Beraun if you have any questions.
