• You must complete a separate form for each type of school that you are applying to. For example, if you are applying to MD and DO programs, you will need to complete this Google Form twice.

• This form is to be used by an applicant furnishing his/her consent to the Office of Prehealth Advising and the University at Buffalo’s Prehealth Committee to release the Preprofessional Health Committee Letter Packet, which is inclusive of the Preprofessional Health Committee letter and all supporting letters of reference. This release is required under the Family Education Rights and Privacy Act or 1974, P.L. 93-380.

• If an applicant is applying to offshore MD or post-bac programs, please consult a Prehealth Advisor before completing this form.  

• The Preprofessional Health Committee Letter Packet will be kept in the Office of Prehealth Advising for five (5) years. The Preprofessional Health Committee file may ONLY be forwarded to professional health schools in support of professional health school applications.