Adams House Pre-Health Intent to Apply 2021-2022
Answer yes to the below question *only* if you intend to apply to medical school for matriculation in the Fall of 2021 or you are a graduating senior who intends on applying in the future. Alumni only need to attend if you applying this coming cycle.

Note that this form is not a binding commitment to apply, but it is necessary.

This form is due on Monday, February 22nd, 2021.

As always, email adams-medical@hcs.harvard.edu if you have any questions.
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Email *
First Name *
Last Name *
Preferred Name *
Phonetic Pronunciation of First and Last Name *
Preferred Gender Pronouns *
Non-exhaustive list of Examples: He/his, She/Hers, They/Them
Permanent Email Address (not college email) *
One that we can keep in touch with you after graduation and that you will check religiously throughout the application cycle
Phone Number *
Year of Graduation (numbers only) *
You need to be graduating at least by 2022 to matriculate in 2022
Do you intend to apply to medical school for matriculation in Fall of 2022? *
This means you would submit your application in May/June 2021. If you are a senior graduating but not applying in 2022, please let us know which year you intend to apply in. This decision is not binding - if you're not sure please select 'Other' and use the comment field below to tell us what you're thinking.
Who is your NRT? Have you communicated with them in the past six months?  If you do not have one or do not know please indicate. *
Please elaborate on your clinical/shadowing experience. *
Include specifics like hours and who/what
Total Harvard GPA *
Have you taken the MCAT? *
MCAT total and Breakdown CPB/CARS/BIO/PS (with dates taken, if taken) *
If not taken, type N/A
Date/Plans for Future MCAT (if planning on taking/retaking)
Comments? Questions? Concerns?
We will collect all questions and make sure that those topics are answered
Programs considered? *
Ones listed below are the only ones that might affect how we advise your AMCAS or other health programs -- other programs, MPH, MD/MBA, often you apply for while in medical school.
Required
A copy of your responses will be emailed to the address you provided.
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