Office of
Graduate
Medical
Education

Registration Form for Incoming Residents

Complete this on-line form by April 15, 2009.

(Additional course offerings that begin before IRW are explained on this form). A detailed schedule will be mailed to you in May. This is a mandatory week for all residents beginning training at the University at Buffalo.

There is a $40.00 registration fee for medical and dental residents.  Upon completion of this form you will receive further instructions.

Please register on-line by completing this form

Please Complete the entire form

Please select what you are registering for:
Incoming Resident Week, June 22-26, 2009
July 1, 2009 Orientation
Other

Please contact with any questions:
Last Name:
First Name:
Middle Name:
Your E-mail:
Degree: M.D.
M.B.B.S.
D.O.
D.D.S.
Other
Date of Birth: (Month/Day/Year)
Gender: Female
Male
Have you accepted a categorical or preliminary position: categorical
preliminary
Are you a University at Buffalo medical school graduate?
YesNo
If you have ever been in another residency within the University at Buffalo indicate program name and dates.
Dates:(Month/Day/Year)
Are you a U.S. Citizen? Yes
No
Social Security #
(for payroll purposes) if you have one.