Forms

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	Notification to the Dean of a scheduled qualifying examination. Form instructions. Updated October 2011.
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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