Please select the items you are requesting.
Medical School Student transcript:(unsigned; for your personal use)
Official Medical School transcript:(signed, sealed, and mailed to a third party)
Verification of Diploma:
Replacement of Medical school diploma:(lost, damaged or name change)
(Further instructions on New/Replacement Medical School Diplomas)
Matriculation/graduation dates and degree received:
Other?:(Licensure Form, Deferment Form, and any other Accompanying Document)
I will Pick Up:
Please FAX to:
Please Email to:
Mail this information to: (You MUST provide a complete name and address of the receiving institution. Please use the COMMENT area for additional mailing instructions.
City, State, Zip:
OR FAX information to:
A mailing address is REQUIRED for all documents to be forwarded to a third party, even if FAXing is requested, as the original document will then be mailed.
Date of Birth:
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Last Update: 01/30/14