Prehealth Committee Addendum Application

You may save a partially completed application and come back at a later date to complete it. If you select this option, you will be emailed a link where you may access your application for up to 30 days.

Fields marked with an asterisk (*) are required.

Your Information

Name*
Street Address
Street Address
Please check the types of professional schools to which you are applying. (Check all that apply.)*

Letters of Recommendation

Please list ONLY the letters of recommendation you are planning on utilizing for your current application. Mark if the letters are new or original letters from your initial Committee Packet.

Recommender 1: Name*
Recommender 1 is submitting a:*
Add a second recommender?*

Recommender 2

Recommender 2: Name*
Recommender 2 is submitting a:*
Add a third recommender?*

Recommender 3

Recommender 3: Name*
Recommender 3 is submitting a:*
Add a fourth recommender?*

Recommender 4

Recommender 4: Name*
Recommender 4 is submitting a:*
Add a fifth recommender?*

Recommender 5

Recommender 5: Name*
Recommender 5 is submitting a:*
Add a sixth recommender?*

Recommender 6

Recommender 6: Name*
Recommender 6 is submitting a(n):*
Add a seventh recommender?*

Recommender 7

Recommender 7: Name*
Recommender 7 is submitting a(n):*

Test Score Information

Which entrance exam did/will you take? (Select only one.)*

MCAT #1

Example: Dec. 15, 2012
Add a second MCAT score?*

MCAT #2

Example: Dec. 15, 2012
Add a third MCAT score?*

MCAT #3

Example: Dec. 15, 2012

Upcoming MCAT Exam

Example: Dec. 15, 2012
I don't currently have an MCAT exam scheduled, but plan to schedule one.

DAT #1

Example: Dec. 15, 2012
Add a second DAT score?

DAT #2

Example: Dec. 15, 2012
Add a third DAT score?

DAT #3

Example: Dec. 15, 2012

Upcoming DAT Exam

Example: Dec. 15, 2012
I don't currently have a DAT exam scheduled, but plan to schedule one.

OAT #1

Example: Dec. 15, 2012
Add a second OAT score?

OAT #2

Example: Dec. 15, 2012

Upcoming OAT Exam

Example: Dec. 15, 2012
I don't currently have an OAT exam scheduled, but plan to schedule one.

Academic Updates

Remember that you must submit an official or unofficial transcript for EACH undergraduate or graduate institution in which you enrolled and completed coursework since you last completed the Committee process.

Undergraduate Education

Advanced Education (if applicable)

Please provide information regarding your graduate education at the University at Buffalo and/or any other institution.

Honors and Awards

Work and Activities

The following sections are designed to parallel the application instructions of the professional health schools. These should be experiences since you last completed the Committee process and were chosen in an effort to enrich your preparation for the professional health school.

The Work and Activities section of this application is designed to give you the opportunity to tell the Committee what new and current work experience, extracurricular activities, and/or publications you have completed and would like to bring to the attention of the professional health schools to which you are applying.

The experiences are divided into these sections:

  • Clinical Research, Volunteering and Shadowing
  • Employment
  • Hobbies and Interests

Enter only your latest and notable experiences. Professional health schools will be interested in quality, not quantity. Enter each experience only once.

Experience Name: Enter the name of the experience or the title you help during the experience. If this experience has no generalized name, choose a name that you feel best describes the experience (i.e., shadowing, internship, volunteering, etc.).

Experience Type: Enter the type of profession this experience involved, if it was interactive, if it was a workshop or what you did during this experience.

Experience Dates: Include the start and end dates for each experience. Some experience types, such as presentations/posters and publications, require only one date. For current experiences (those in which you are still involved and which do not have a known end date), write "Until Present" for the end date.

Organization Name: Enter the name of the organization through which this experience occurred.

Average Hours Per Week: Enter the number of hours each week that you devoted to this experience. If it was a seminar or a one-day experience, enter total number of hours.

Contact Name: Indicate a person the professional health schools may contact to verify that this experience occurred. For example, you may enter your supervisor or the individual coordinating a particular program,. If the experience was a student-organized group and there is no advisor, you may list a staff member in the student affairs/activities office who can verify your experience. You are required to provide a phone number and/or email address for this contact person.

Experience Description: This section is where you will describe your position, your duties, and how this helped you to guide you and support your decision for this profession. Be sure to include the location of the facility. The suggested format is:

  • Describe the nature of the organization or experience.
  • Describe what you did or accomplished.
  • Describe what you learned.
  • Describe how you feel this experience has further assisted you in preparing for this particular profession since you last applied.


Clinical Research, Shadowing and Volunteering Involvement

Regarding clinical research and shadowing involvement, briefly explain what exposure this has given you to medicine/healthcare, emphasizing any direct interaction with patients, work in clinics, shadowing, and other medical-related experience.

Regarding volunteering involvement, briefly explain any opportunities in community service and volunteering. Highlight your role in each setting and what you have learned and how it has assisted in your development.

You may enter up to 3 experiences below. Please enter only significant experiences and remember that professional health schools are more interested in quality than in quantity.

Clinical Research, Shadowing and Volunteering Experience 1

Ex., Aug. 15, 2019 - Nov. 20, 2019
Add a second clinical research, shadowing or volunteer experience?

Clinical Research, Shadowing and Volunteering Experience 2

Ex., Aug. 15, 2019 - Nov. 20, 2019
Add a third clinical research, shadowing or volunteer experience?

Clinical Research, Shadowing and Volunteering Experience 3

Ex., Aug. 15, 2019 - Nov. 20, 2019

Employment

Please provide a brief description of your employment you engaged in since you last came through the Committee process. You may enter up to 3 employment experiences.

Employment Experience 1

Ex., Aug. 15, 2019 - Nov. 20, 2019
Add a second employment experience?

Employment Experience 2

Ex., Aug. 15, 2019 - Nov. 20, 2019
Add a third employment experience?

Employment Experience 3

Ex., Aug. 15, 2019 - Nov. 20, 2019

Hobbies and Interests

Is there anything else we should know about you? This section should focus on your hobbies, interests and activities worthy of mention. Be sure to emphasize your talents/interests (e.g., martial arts, music, etc.).

You may enter up to 3 experiences below. Please enter only significant hobbies and interests and remember that professional health schools are more interested in quality than in quantity.

Experience 1

Ex., Aug. 15, 2019 - Nov. 20, 2019
Add a second hobbies/interests experience?

Experience 2

Ex., Aug. 15, 2019 - Nov. 20, 2019
Add a third hobbies/interests experience?

Experience 3

Ex., Aug. 15, 2019 - Nov. 20, 2019

Additional Information

Institutional Action: Honor Statement

Have you been the subject of any disciplinary action due to unacceptable academic performance or conduct violations at the University at Buffalo or any other college or university since you complete the Prehealth Committee process?*
Please read the statement and check to affirm that it is correct.*

Signature

Student signature is required. Please indicate your preferred format.*
Use your mouse or finger to draw your signature above
MM/DD/YYYY
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