Electives Forms

The following forms can be downloaded to your micro (either PC or MAC). Click on the form you need. The form (.doc) will be saved on your harddrive, probably in the directory C:/Windows/Temp/. If you do not find it there, simply do a "Find" and see where it ended up. You can open the file in Microsoft Office 97 Word (or later versions) and print as many copies as you need. If you have printing problems, use the pdf format (see below).

The forms are also available in Adobe Acrobat format (.pdf). You can download the free Adobe Acrobat Reader.

Problems? Please contact the Electives Coordinator, med-electives@virginia.edu, or call 434/924-5579.

Elective chart: (chart.pdf)

Add/Drop form: (add.doc) (add.pdf)

Specially Arranged Form: (special.doc) (special.pdf) - Must be scheduled at least one month prior to beginning

Away Form (for LCME, non-UVA sites in United States): (away.doc) (away.pdf)

Elective Evaluation Form - to be filled out by supervisor: (eval.doc) (eval.pdf)

Selective Evaluation Form - to be filled out by supervisor: (select.doc) (select.pdf)

Research Form: (research.doc) (research.pdf) - Must be scheduled at least one month prior to beginning

International Rotation (outside United States/Canada): contact April Ballard, Program Supervisor, Center for Global Health 434- 243-6383 - Must be scheduled at least one month prior to beginning. Must complete the UVA-Global Med on-line application; the International Studies Office online data, health and waiver forms in ISO Studio Abroad on the ISO Medical Students page and the School of Medicine International Elective Form must be turned in to Student Affairs (Electives/Selectives Coordinator) at least 1 month prior to beginning.

Block B Form: (Block B Form.DOC) (Block B Form. pdf)

Advisor Form: (Advisor.doc) (Advisor.pdf)

Advisor Change Form: (change.doc) (change.pdf)

  to Electives Menu