Uniformed Services University

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:
 

Letter of recommendation for

Fellowship:
(You will receive a 3rd and 4th yr Dean's letters for this option)

Licensure:
(You will receive a matriculation letter for this option, not a Deans letter)

Employment:
(You will receive a matriculation letter for this option, not a Deans letter)

Residency Training:
(You will receive a 3rd and 4th yr Dean's letters for this option)

Other?:
(You will receive a matriculation letter for this option, not a Deans letter)

Specify Other:
 

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.

Institution Name:
 

Attention:
 

Mailing address:
 

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.

My identifying information is

Rank:
 

Full Name:
 

Service Branch:
 

Mailing address:
 

Graduation Year:
 

Daytime Telephone:
 

Duty/Home Address:
 

Daytime Telephone:
 

City, State, Zip:
 

Email Address:
 

Comments/Additional Information: