Prior to First Class

• Immunization Requirements and Form
• Parking Information and Parking Permits and Maps
• Background Check Form –  email to Camille Sirera
• Photo Consent and Release Form
• Photo Directory Consent and Release Form
• After completing the Student Compliance and Privacy/Security Training (HIPAA), fill out the Training Acknowledgment, then email form publichealth@uchc.edu.

Requirements

1. Application for Credit Waiver, Transfer or Advance Standing (if applicable)
2. IRB Registration and Instructions – email certificate of completion to publichealth@uchc.edu by October 15.
3. IRB Forms for Human Subject Research
4. Learning Contract for Practicum
5. Learning Contract for Field Experience
6. Competency Checklist Fillable Form
7. Intentional Action Form
8. ILE Capstone Project (Plan B) Format Specifications
9. ILE-Proposal-Form
10. ILE Plan A Thesis Evaluation Form
11. ILE Plan B Capstone Project Evaluation Form

For fillable forms, we suggest downloading and saving the form to your computer. Then, open with acrobat reader to complete and save.

For more information, contact the M.P.H. program office at: publichealth@uchc.edu.

Graduate School Forms

Please return all forms to the M.P.H. program office, MC 6325. A copy will be kept on file in the M.P.H. office, and the original forwarded to the Graduate School.

• Graduate School & Registrar’s Forms