Follow the steps to accurately complete your verification statement.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Fill in your name clearly in the designated field at the top of the form.
3. Provide the name of your medical school in the appropriate section.
4. Enter the name of your Urology Residency Training Program as required.
5. Indicate your area of special focus by selecting one option from the provided list: General, Andrology, Endourology, Female, Infertility, Oncology, Pediatric, or Urolithiasis.
6. If applicable, state your fellowship training subspecialty area, including the location and dates of the fellowship.
7. In the designated field, describe your current practice in 100 words or less, providing relevant details about your professional focus.
8. Confirm that the electronic log submission and documentation accurately reflect your consecutive office visits and surgical procedures for the required time period.
9. Complete the candidate section by entering your name and office phone number.
10. Sign the form, ensuring it is duly notarized as required.
11. After completing the form, review all entries thoroughly for accuracy and clarity.
12. Save the changes, download, print, or share your completed form as necessary.

Take the next step in your professional journey by completing your VA ABU Practice Log Verification Statement online today.