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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, jac2g@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 start of the rotation.

Elective Evaluation Form - to be filled out by supervisor: (eval.doc) (eval.pdf) for Away Rotations, Research & Specially Arranged Electives Only!!

**All other UVA Elective evaluations must be completed in OASIS**

Research Proposal Form: (research.doc) (research.pdf) - Must be scheduled at least one month prior to start of the rotation. Students Participating in Clinical Research should review this Information: (HIPAA identifiers.docx) (HIPAA identifiers.pdf)

Research Elective Final Credit Form: (research elective final credit.doc) - Must be submitted with student's research final write-up at the conclusion of the project.

• In order to receive credit for any research elective, an evaluation form must be received from the supervisor, the research final credit form and a detailed final report must be submitted. This can be a written summary of the work done during the elective, a completed manuscript, poster presentation, powerpoint , etc. and should be submitted within one month of completing the research elective. Delayed/late submission of the final report was a very significant issue last year and can delay certification for graduation.

For this reason:

o Final research elective reports should be submitted to the Electives Coordinator (Ms. Clarke) within one month of completing the elective. Any students doing research from Rotation 1-11, if the final report is not received by Match Day (March 18th, 2016), students will be penalized one week of lost credit for each part of a week past that deadline. For students doing research in Rotations 12-14, final reports as well as all evaluations must be received by May 5th, 2017.

International Rotation (outside United States): At least one month prior to start of the rotation, follow the Graduate Student Registration instructions on the International Studies Office Studio Abroad. Also the SOM International Form must be turned in to Student Affairs (Electives Coordinator) at least 1 month prior to the start of the rotation. For Scholarship information, contact April Ballard, Program Supervisor, Center for Global Health 243-6383.

Block C Form (SMD18):(Block C Form)(Block C Form.pdf)

Residency Advisor Form (SMD18): (advisorform.doc) (advisorform.pdf)

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

Residency Advisors List (SMD18): (SMD18 Residency Advisor List)


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