Get Uhsa

This guide provides a step-by-step approach to completing the Uhsa clinical registration form online. By following these clear instructions, users can navigate the form seamlessly, ensuring that all necessary information is accurately submitted.

Follow the steps to complete the Uhsa form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select the trimester you are enrolled in from the dropdown menu marked 'Trimester Enrolled'.
3. Input your enrollment date in the field labeled 'Date Enrolled'. Ensure the format is consistent.
4. Enter your full name in the section specified for 'Student Name', including first, middle, and last names.
5. Provide your student identification number in the allocated field beneath 'Student Identification Number'.
6. Specify your clinical pathway by selecting one of the options: Traditional, Non-Traditional, or PARP.
7. Fill in your mailing address and telephone number in the respective fields.
8. Complete your permanent address and corresponding telephone number.
9. Indicate your citizenship in the section available for 'Citizenship'.
10. Enter your date of birth in the specified format for 'Date of Birth'.
11. Mention your highest degree attained in the field labeled 'Highest Degree Attained'.
12. Input the name of the institution where you obtained your highest degree.
13. Provide your email address in the designated section for 'Email Address'.
14. Fill in your cell phone number in the provided space.
15. Record the details for clinical rotations, particularly the hospital name and mentor name.
16. Finally, sign and date the form in the spaces provided for the student signature and date.
17. Once completed, save your changes, download the form, print it, or share it as necessary.

Take the first step and fill out the Uhsa form online today.