Get Visiting Medical Student Application Form - Staten Island University ... - Siuh

This guide provides comprehensive instructions on how to accurately complete the Visiting Medical Student Application Form for Staten Island University Hospital. Follow these steps to ensure your application is filled out correctly and submitted on time.

Follow the steps to successfully complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Complete the applicant’s demographics section, including your full name, telephone number, address, medical school, year in medical school, medical school address, and email address. Be sure to fill in all fields without leaving any blank spaces.
3. In the provided list boxes, indicate the core clerkships you will have completed before beginning the elective, such as Medicine, Surgery, Pediatrics, Women’s Health, Psychiatry, and Neurology. Make sure to select only those clerkships you have finished.
4. List your preferred electives in order of choice. It is essential to prioritize your options as this will assist the hospital in accommodating your preferences.
5. Fill in the dates section by noting the elective dates you are requesting. Remember that all electives start on the first Monday of the month and end on the last Friday.
6. Once you have completed your section, ensure that the Medical School Dean or designee completes their certification section. This includes verifying your academic standing, malpractice insurance coverage, health insurance status, HIPAA training completion, performance report requirement, and attaching an official transcript.
7. Confirm that the dean has signed and affixed the school seal where indicated. This is a crucial step for the validity of your application.
8. After filling out all sections of the form, review your entries for accuracy. Save any changes made to your application.
9. You can then download, print, or share the completed form as required. Be sure to submit it along with your passport photo to the appropriate department address listed for your electives.

Prepare and submit your application online today to secure your medical student rotation.