Recommendation Waiver Form for Medical School Application
Please complete this form to indicate your waiver decision regarding access to your recommendation letters as part of your medical school application.
Applicant Full Name
*
First Name
Last Name
Applicant Email Address
*
example@example.com
Applicant Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Application ID (if applicable)
Medical School or Program Name
*
Recommender Full Name
*
First Name
Last Name
Recommender Email Address
*
example@example.com
Relationship to Recommender
*
Please Select
Professor
Advisor
Employer/Supervisor
Mentor
Other
Do you wish to waive your right to access this recommendation letter?
*
Yes, I waive my right to access this letter.
No, I do not waive my right to access this letter.
Additional Comments (optional)
By signing below, I acknowledge my waiver decision above and authorize the recommender to provide a recommendation for my application to the medical school/program listed above.
*
Date of Submission
*
-
Month
-
Day
Year
Date
Submit Waiver Form
Submit Waiver Form
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