I certify that all of the application's information is my own work, factually true, and honestly presented. My electronic submission of my full name below is equivalent to my signature and is certification of the accuracy and completeness of the information I have provided. Further, I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I certified be false. I also understand that as a student, it my responsibility to understand the licensure requirements of the state or country where I seek to be licensed and that it is not the responsibility of UHSA if those state or country regulations change during my medical education.
Please accept the terms & conditions to submit this form.