Click the "next" button below to continue to the Release of Pre-health Committee Packet and Waiver or Retention of Rights.
In accordance with the Family Educational Rights and Privacy Act of 1974, P.L. 93-380 (amended), reference to Section 438(a)(1)(B).
If you wish to obtain a Committee Evaluation to support your application to professional school, you must complete and sign the sections below.
The function of the Pre-Health Committee is to provide advice and guidance to students seeking admission to health profession schools. Our policy of discussing fully and completely with a student the information and records available to us pertaining to him/her will remain unchanged regardless of whether or not a waiver, as specified under the Privacy Rights Act, is signed. A number of faculty members feel that to be fully effective, evaluations should be confidential – in other words, that confidentiality is what makes an evaluation most worthwhile. We, therefore, urge that you carefully consider whether or not to sign the waiver of your right of direct access. Remember: whether you sign the waiver or not, nothing is transmitted unless you tell us to do so in writing, and it is your right to know whose statements are being forwarded.
By signing (typing your legal name) in the space below, you are certifying that all information on this form is correct and that you are the person completing this application.
When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification.