Forms

Academic Support | Admissions | ISO | Orientation | Postdoctoral Affairs | Registrar

Academic Support Forms

Evaluation Form Primary User Description

Evaluation - Annual

Student

Evaluation for PhD students to be completed by the student and the committee at least once annually (every 12 months). Policy
Updated June 2011.

Evaluation - Rotation (Faculty)

Faculty

Rotation evaluation for 1st year PhD students to be completed by the rotation lab mentor. Policy | Updated September 2011.

Evaluation - Rotation (Student)

Student

Rotation evaluation for 1st year PhD students to be completed by the student. Policy
Updated June 2011.

Expectations Document Primary User Description

Expectations of Graduate Students

Student

Outlines the 14 key expectations of URMC SMD graduate students.
Updated January 2011.

Expectations of Research Advisors

Faculty

Outlines the 15 key expectations of URMC SMD research advisors.
Updated January 2011.

Admissions Forms

Form Primary User Description

Master's Admit/Reject

Faculty

Complete when making admissions offers to the Dean for Master's applicants.
Updated April 2011.

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International Services Office Forms

Form Primary User Description

International Services Office Forms

International Students/Postdocs

Forms and information required to obtain and maintain visas for work or study in the US.

Short Term Absence Notice

International Students/Postdocs

Provides the Program Coordinator with information to assist International students with re-entry into the U.S.
Updated June 2011.

Visa Delays and Denials Report Form

International Students/Postdocs

Used to provide information to the ISO regarding visa delays and denials.

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Orientation Forms for Incoming Graduate Students

Form Primary User Description

Employment Eligibility Verification I-9

Program Coordinator

Employment form required by the US Department of Homeland Security.
Expires 8/31/12.

Federal Tax Withholding W-4

Program Coordinator

Payroll form required by the Internal Revenue Service. 2011 version.

HIPAA Training

Program Coordinator

Certifies that the student has completed HIPAA training within 30 days of matriculation.
Updated November 2011.

Intellectual Property Agreement

Program Coordinator

Certifies that the student has read and understands the University's intellectual property policy and practices.
Updated November 2009.

NYS Tax Withholding IT-2104

Program Coordinator

Payroll form required by New York State Department of Taxation and Finance.
05/11 version.

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Postdoctoral Affairs Forms

Form Primary User Description

520 Appointment Form via HRMS

Departmental Administrator

Guide to Benefits and Job Codes for Postdoctoral Appointees

Annual Review

Postdoctoral Appointee

Developed by FASEB, sample annual review form to be used by postdoctoral appointees.

Career Development Plan

Postdoctoral Appointee

Developed by the Clinical and Translational Science Institute, this is another example of a development plan that a postdoc can use.

Individual Development Plan

Postdoctoral Appointee

Developed by FASEB, this is the recommended tool for identifying professional development needs and career objectives of postdocs. The IDP also serves as a communication tool between postdocs and their mentors.

Offer Letter Template

Faculty

Template for postdoctoral appointment offer letter. Postdoctoral Appointment Policy
Updated July 2011.

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Registrar Forms

Exam-related Form Primary User Description

Academic Calendar

All

Academic calendar for graduate programs in the School of Medicine and Dentistry for the academic year 2011-2012.

Defense Committee Email Addresses

Program Coordinator

List of faculty members and approved guest members who will serve on a graduate student's final oral exam committee.
Updated October 2011.

PhD Defense Appointment

Program Coordinator

Notification to the Dean of a scheduled doctoral defense. Instructions
Updated June 2011.

PhD Diploma Form

Student

Used to indicate exactly how a graduate's name should appear on his/her diploma.
Updated November 2011.

Program of Study - Master's Degree

Program Coordinator

List of completed course requirements for the degree MA, MPH, MS. Updated Jan. 2012.

Program of Study - PhD Biomedical

Program Coordinator

List of completed courses and research credit hours for the PhD degree in the biomedical sciences. Updated April 2011.

Program of Study - PhD Health

Program Coordinator

List of completed courses and research credit hours for the PhD degree in the health sciences. Updated July 2011.

Program Statement on Completion of PhD Requirements

Program Coordinator

Certifies that the student has completed all PhD degree requirements.
Updated June 2011.

Qualifying Exam Appointment

Program Coordinator

Thesis Registration Permission

Program Coordinator

Indicates advisor approval to submit a PhD thesis for defense. Updated April 2011.

Registration Form Primary User Description

Add/Drop

Student

Form updated October 2011.

Add/drop form instructions

2011-12 Refund Schedule

Bursar Statement

Student

Used to notify Bursar's Office of method of payment for semester's tuition.

Non-Matriculated Financial Statement

Student

Financial statement for non-matriculated students.

Non-Matriculated Registration

Student

Course registration form for non-matriculated students. Form must be completed electronically. Updated August 2011.

Payment Agreement

Student

Student acknowledgement of financial responsibility of tuition and fees.

Student Record Form Primary User Description

Address Change

Student

Used to change local or permanent address. International students, see ISO Forms.

Change of Status

Program Coordinator

Submitted for changes such as degree, major, time status, termination/completion.

Updated August 2011.

Course Transfer Credit

Student

Request to transfer credits based on courses completed at other colleges and universities.
Form instructions | Policy
Updated May 2011.

Course Waiver

Student

Request to waive courses based on courses completed at other colleges and universities.
Form instructions. Updated May 2011.

Enrollment Verification Request

Student

Used to confirm enrollment status or verification of graduate degree(s) earned for employment purposes, insurance, international travel letters, etc.

Exit Interview

Student

Provides the Senior Associate Dean with graduating students' plans for the future.
Updated December 2011.

Incomplete Grade Contract

Faculty

Used to notify Registrar that a student has completed all coursework except for the final exam. Updated April 2011.

Leave of Absence Request

Student

Used to request a short-term leave of absence from the degree program.
Updated May 2011.

Name Change Request

Student

No form required. Simply provide the Registrar with a legal form of identification that bears your new name.

Parental Leave Request

Student

Used to request a parental leave of absence from the degree program. Policy
Updated August 2011.

Supplemental Grade Notice

Faculty

Used to notify the Registrar of a change to an incompleted grade. Updated April 2011.

Transcript Request

Student

To request an official University of Rochester transcript.

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