OFFICE OF THE REGISTRAR
How May We Help You?
Please complete the information below. Leaving the requested information blank may result in processing delays. Please allow 2
business days, once received for processing. If you would like to request an official transcript, please complete the transcript
request form.

Enrollment Verification (confirms enrollment status, good standing, dates of attendance, etc.)
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Certification of Baylor Medical School Diploma
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Malpractice Insurance Letter (generally required for away electives)
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Letter Stating Requirements for USMLE Step I or II (CK and CS) prior to graduation
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National Board Scores (Subject Examinations): ______________________________________
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Other (Please Explain) ___________________________________________________________
STUDENT INFORMATION
Name: __________________________________________________ BCM ID Number: _____________________
Local Address: __________________________________________________________________________
__________________________________________________________________________
Telephone Number: _____________________
Academic Program (Med, Grad, MD/PhD, Allied Health, Tropical Medicine)_________________________________
Dates of Attendance________________________________________ Date Graduated________________
Today’s Date______________________ Signature_____________________________________________
HANDLING INFORMATION:
Will Pick Up
 Please Mail to the Following Address:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Submit completed request to the Office of the Registrar
One Baylor Plaza M210, Houston, TX 77030
Fax: (713) 798-1518
Email: [email protected]
Office Use Only
Processed date/Initials: __________________
10/24/14 Z:\REGISTRAR\REGISTRAR - ACTIVE\FORMS\FORMS\How May We Help.doc
Date: ____________________