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Pre-Health Guidance Center
Sign-up for a 15-minute Guidance Appointment
Your Information
First Name
Last Name
Email
State
Zip Code
Country
Are you currently a Community College Student?
(A student who is currently enrolled full time in a community college)
Yes
No
Decline to Respond
Do you identify as a Transfer Student?
(A student who began their undergraduate career at a community college then transferred to a traditional 4-year university)
Yes
No
Decline to Respond
Do you identify as First Generation?
(A student whose parent or parents' highest form of education is one of the following: less than a high school degree; have earned a high school degree (high school diploma or equivalent); some college, but no degree.)
Yes
No
Decline to Respond
Do you identify as Underrepresented in Medicine?
(Underrepresented in medicine means racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population. For further context:
https://www.aamc.org/what-we-do/equity-diversity-inclusion/underrepresented-in-medicine
)
Yes
No
Decline to Respond
What is your current academic level or professional position?
Parent or Guardian
Middle School
High School
College - Freshman
College - Sophomore
College - Junior
College - Senior
Graduate or Professional Student
Career Change or already graduated but not a Postbacc or Graduate Student
Academic Advisor / Counselor / Faculty
What undergraduate institution do you currently attend or are enrolled at?
What graduate institution do you currently attend / are enrolled at?
What is the most recent institution you attended / graduated from?
Please answer the below questions.
What institution do you represent?
What is your position / title?
How did you hear about our Pre-Health & Pre-Med Guidance Center?
Email
DGSOM website
Other website
Social media
Referral
Conference/Fair
Presentation
Other
Would you like to join our mailing list?
(You will receive reminders about our upcoming webinars, tabling events we will be attending, as well as deadlines reminders for our summer Pathway Programs)
Yes - I would like to join the Office of Outreach & Pathway Programs' mailing list
No - I would not like to join the Office of Outreach & Pathway Programs' mailing list
Please select which areas of interest you would like to receive emails about:
DGSOM Pathway Programs
Summer Health Professions Education Program (SHPEP)
Pre-Medical Enrichment Program (PREP)
Re-Application Program (RAP)
DGSOM Medical School Tracks
Traditional MD Program
PRIME-LE
Medical Scientist Training Program (MSTP / MD, PhD)
Experiences / Opportunities
Volunteer Opportunities
Shadowing Opportunities
Research Opportunities
Other Pathway Research Programs
Other Health Professions
Nursing
Dentistry
Public Health
Other
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