University of Health Sciences Antigua

Personal Information

First Name^*

Middle or Additional Names

Last Name^*

Professional Profile Photo^*

Upload a professional passport-sized photograph of yourself which will be used for your student ID card and your portal profile picture. This can be changed at a later date.

Student ID Number

Date of Birth^*

Country of Birth^*

Country of Citizenship^*

Gender^*

Email^*

Primary Telephone^*

Mailing Address

Address^*

Address 2

City^*

State/Province^*

ZIP or Postal Code

Country^*

Emergency Contact

Emergency Contact Name^*

Emergency Contact Telephone^*

Relationship^*

Program Information

Application Type^*

Former students who are transferring medical school credits to UHSA should not complete this application. Instead, please begin the Transfer process by starting a new online application at www.uhsa.ag.

Desired Readmission Start Date^*

Medical school entry dates occur in January, May, and September.
Nursing school entry date only occur in September.

Desired Placement^*

Additional Information

First Enrollment Date at UHSA^*

Reason for leaving UHSA:^*

Please explain below

Why are you returning to UHSA?^*

Have you been employed since leaving UHSA?^*

If Yes, please indicate employer

Have you taken courses at another college?^*

If Yes, please provide the school and course names

If Yes, please indicate employer

If you experienced academic difficulties, how has your study process improved?

Are there any special factors that you wish to share with the Committee reviewing your readmission application?^*

Graduation Requirement^*

I understand that I must meet the following requirements to graduate from UHSA: Complete all required Basic and Clinical Science courses; Receive a passing score on USMLE Step 1 and USMLE Step 2 CK; Complete the Application for Graduation. I also understand that the Puerto Rico board examination (also known as “Reválida”) is not acceptable as a graduation requirement.

Fees

Mandatory Fees
	Readmission	1000
	Total	1,000.00

Any payments made in accordance with this form submission shall, once they are paid, not be refundable nor creditable for any reason whatsoever.

I certify that all of the application's information is my own work, factually accurate, and honestly presented. My electronic submission of my full name below is equivalent to my signature and is a 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 is 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 the University of Health Sciences Antigua if those state or country regulations change during my medical education.

I hereby grant permission to the University of Health Sciences Antigua to reproduce any portion of photo images or videos that have been taken on-campus, at clinical clerkships, or at any university-sponsored event to be used for the purpose of promotional publications, which can include but is not limited to, books, cards, calendars, invitations, and websites without any more compensation or recognition given to me. Furthermore, I grant creative permission to alter the photograph(s). I do not grant permission to resale or use the photographs in a manner that would exploit or cause malicious representation toward me or my company and associates.

Please accept the terms & conditions to submit this form.

Apply for Readmission

Personal Information

Mailing Address

Emergency Contact

Program Information

Additional Information

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