Away Rotation Forms

• Application and Evaluation Form for Senior Electives

Students requesting an away rotation must ensure completion of all sections (Section I by the student; Section II by the UT Department; Section III by the Office of Medical Education; and Section IV by the cooperating instutition). Once completed, this form must be returned to the Office of Medical Education via mail or fax.

Students must have completed a criminal background check before being approved for an away rotation.

Evaluation of Students in Clerkships and Electives

This form is to be completed for each student in a clerkship. Students doing away rotations must provide this form to the appropriate personnel at the cooperating institution. The completed form should be returned to the Office of Medical Education via mail or fax.

International Training Rotation Forms

• International Travel Memo (dated 7/29/02)
• International Travel Release (no advisory)
• International Travel Release (advisory)

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Days Until Site Visit

Contact Us

Office of Medical Education

910 Madison Avenue, Rm 1002
Memphis, Tennessee 38163
Phone: 901-448-5506
Fax: 901-448-1488

Associate Dean:
Robert G. Shreve, Ed.D.

Executive Dean:
David M. Stern, M.D.