Online Respiratory Advising Video and Documentation Form

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Please view the 30 minute Respiratory Advising video. Students who wish to apply to the program must view the video in its entirety and complete the form below as one of the mandatory steps in the application process. To be able to view in full screen, please go to: Click HERE

Respiratory Advising Video and Required Documentation

First Name *

Last Name *

Email address *

Phone *

Adress *

City, State *

zip code *

OD ID number (If you have one)

today's date *

YYYY

Date of Birth *

YYYY

I confirm that I watched the video in its entirety. *

Yes I did.

I give permission for a Respiratory full time faculty to contact me *

Yes

Which of the following describes your Math and Science coursework? *

I need advising to determine if my Math and Science coursework meets prerequisites for the program.

Have you completed a two or four year degree? If so, what was the field of study? *

I am willing and able to accept an annual flu shot and required vaccines. *

Yes

I am aware there are two semesters within the program that are less than six credit hours. *

Yes

Do you have any medical experience? If so please describe *

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