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Registrar
A.T. Still University Home

Forms

KCOM Clinical Educational Affairs MSPE and LOR Request Form

The Medical Student Performance Evaluation (MSPE) and Letters of Recommendation (LOR) (from third & fourth year preceptors) are obtained from the Clinical Educational Affairs Office for KCOM third and fourth year students and graduates. MSPE’s are not available before 2001. The MSPE cannot be released directly to the student/graduate. LOR’s are available for up to 5 years following graduation. LOR’s can only be released directly to the student/graduate if you did not waive your right to see the letter.

Requests for Transcripts should be made to the Registrar’s Office.

Please complete the form below to make your request. Please allow 2-4 business days for processing.

* Required fields

Your First Name:

*

Your Last Name:
(at time of graduation)

*

Address:

*

City:

*

State:

*

Zip Code:

*

Phone:

*

Email:

*

Graduation Year:

*

Check appropriate box: (they have to check at least one of these boxes) *

Medical Student Performance Evaluation

Letter(s) of Recommendation

 

Letter Writers:









All LOR’s on file

You can request documents to be sent to up to three contacts per request form.
(Include Department or Contact Person)

Request 1:

 

Send via email to:

 

Request 2:

 

Send via email to:

 

Request 3:

 

Send via email to:

 

*

By checking this box, I authorize Clinical Educational Affairs to release the requested documents on my behalf.