{"id":357,"date":"2017-05-16T17:14:35","date_gmt":"2017-05-16T17:14:35","guid":{"rendered":"https:\/\/hmsc.unc.edu\/?page_id=357"},"modified":"2025-09-05T19:59:29","modified_gmt":"2025-09-05T23:59:29","slug":"forms","status":"publish","type":"page","link":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"<h2>Recurring Forms<\/h2>\n<table style=\"height: 110px;width: 100%;border-collapse: collapse;border-style: solid;border-color: #000000\">\n<thead>\n<tr style=\"background-color: #08446d\">\n<td style=\"width: 18.5522%;height: 18px;border-style: solid;border-color: #000000;text-align: center\">\n<p><strong><span style=\"color: #ffffff\">Form<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 21.4478%;height: 18px;border-style: solid;border-color: #000000;text-align: center\">\n<p><strong><span style=\"color: #ffffff\">Initially Completed By:<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 20%;height: 18px;border-style: solid;border-color: #000000;text-align: center\">\n<p><strong><span style=\"color: #ffffff\">Reviewed By:<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 20%;height: 18px;border-style: solid;border-color: #000000;text-align: center\">\n<p><strong><span style=\"color: #ffffff\">Target Deadline:<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 20%;height: 18px;border-style: solid;border-color: #000000;text-align: center\">\n<p><strong><span style=\"color: #ffffff\">Submit To:<\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"height: 23px\">\n<td style=\"width: 18.5522%;height: 23px;border-style: solid;border-color: #000000;text-align: center\"><strong>Contract Letter<\/strong><\/td>\n<td style=\"width: 21.4478%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">Faculty<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">Student<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">Summer\/Early Fall &#8211; Annually<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">HMSC Director<\/td>\n<\/tr>\n<tr style=\"height: 23px\">\n<td style=\"width: 18.5522%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\"><strong>Plan of Study<\/strong><\/td>\n<td style=\"width: 21.4478%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\" colspan=\"2\">Student and Mentor<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\">Each Semester (As needed)<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\">N\/A<\/td>\n<\/tr>\n<tr style=\"height: 23px\">\n<td style=\"width: 18.5522%;height: 23px;border-style: solid;border-color: #000000;text-align: center\"><strong>IDP<\/strong><\/td>\n<td style=\"width: 21.4478%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">Student<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">Mentor<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">Late Spring\/Early Fall &#8211; Annually<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center\">No Submission Required<\/td>\n<\/tr>\n<tr style=\"height: 23px\">\n<td style=\"width: 18.5522%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\"><strong>Program and Mentor Evaluations<\/strong><\/td>\n<td style=\"width: 21.4478%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\">Student<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\">Mentor (optional)<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\">Spring &#8211; Annually<\/td>\n<td style=\"width: 20%;height: 23px;border-style: solid;border-color: #000000;text-align: center;background-color: #c9c9c9\">HMSC Director<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>One Time Forms<\/h2>\n<table style=\"height: 285px;width: 100%;border-collapse: collapse;border-color: #71a3c1;border-style: solid\">\n<tbody>\n<tr style=\"background-color: #08446d;height: 18px\">\n<td style=\"width: 18.2626%;text-align: center;height: 18px;border-color: #000000\">\n<p><strong><span style=\"color: #ffffff\">Form<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 20.9652%;text-align: center;height: 18px;border-color: #000000\">\n<p><strong><span style=\"color: #ffffff\">Initially Completed By:<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 19.0347%;text-align: center;height: 18px;border-color: #000000\">\n<p><strong><span style=\"color: #ffffff\">Reviewed By:<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 20.9653%;text-align: center;height: 18px;border-color: #000000\">\n<p><strong><span style=\"color: #ffffff\">Target Deadline:<\/span><\/strong><\/p>\n<\/td>\n<td style=\"width: 20.7722%;text-align: center;height: 18px;border-color: #000000\">\n<p><strong><span style=\"color: #ffffff\">Submit To:<\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\"><strong>First Year Review<\/strong><\/td>\n<td style=\"width: 20.9652%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Student<\/td>\n<td style=\"width: 19.0347%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Mentor (optional)<\/td>\n<td style=\"width: 20.9653%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Spring Year 1<\/td>\n<td style=\"width: 20.7722%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Educational Review Committee Chair<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\"><strong>Second Year Review<\/strong><\/td>\n<td style=\"width: 20.9652%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Student<\/td>\n<td style=\"width: 19.0347%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">\u00a0<\/td>\n<td style=\"width: 20.9653%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Spring Year 2<\/td>\n<td style=\"width: 20.7722%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Educational Review Committee Chair<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\"><strong><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2020\/06\/Research-Experience-Form.docx\">Research Experience<\/a> (x2)<\/strong><\/td>\n<td style=\"width: 39.9999%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\" colspan=\"2\">Student and Mentor<\/td>\n<td style=\"width: 20.9653%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">By End of Year 2<\/td>\n<td style=\"width: 20.7722%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Jennifer Canders<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\"><strong>Teaching Experience (x2)<\/strong><\/td>\n<td style=\"width: 39.9999%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\" colspan=\"2\">Student and Supervisor<\/td>\n<td style=\"width: 20.9653%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">By End of Year 2<\/td>\n<td style=\"width: 20.7722%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Jennifer Canders<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\"><strong>Dissertation Committee Report (part I and II)<\/strong><\/td>\n<td style=\"width: 20.9652%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Mentor\/Committee<\/td>\n<td style=\"width: 19.0347%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">\u00a0<\/td>\n<td style=\"width: 20.9653%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Spring Year 2 +\/- a semester<\/td>\n<td style=\"width: 20.7722%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Jennifer Canders<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\"><strong>Dissertation Committee Form<\/strong><\/td>\n<td style=\"width: 20.9652%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Mentor\/Committee<\/td>\n<td style=\"width: 19.0347%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">HMSC Director\/Co-Director<\/td>\n<td style=\"width: 20.9653%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Semester Prior to Proposal<\/td>\n<td style=\"width: 20.7722%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">HMSC Director<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\"><strong>Dissertation Proposal Report<\/strong><\/td>\n<td style=\"width: 20.9652%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Mentor\/Committee<\/td>\n<td style=\"width: 19.0347%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">\u00a0<\/td>\n<td style=\"width: 20.9653%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Year 3 or 4<\/td>\n<td style=\"width: 20.7722%;height: 23px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Jennifer Canders<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\"><strong>Dissertation Exam Report (part III and IV)<\/strong><\/td>\n<td style=\"width: 20.9652%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Mentor\/Committee<\/td>\n<td style=\"width: 19.0347%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">HMSC Director\/Co-Director<\/td>\n<td style=\"width: 20.9653%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">Year 4<\/td>\n<td style=\"width: 20.7722%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000;background-color: #c9c9c9\">HMSC Director<\/td>\n<\/tr>\n<tr style=\"border-color: #000000;background-color: #ffffff\">\n<td style=\"width: 18.2626%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\"><strong>Coursework in Fulfillment of Degree<\/strong><\/td>\n<td style=\"width: 20.9652%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Student<\/td>\n<td style=\"width: 19.0347%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">HMSC Director\/Co-Director<\/td>\n<td style=\"width: 20.9653%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Prior to Defense<\/td>\n<td style=\"width: 20.7722%;height: 43px;border-style: solid;text-align: center;vertical-align: middle;border-color: #000000\">Jennifer Canders<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<h2>Forms from the <a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2023\/08\/HMSC-Manual_25-26.pdf\">HMSC Manual<\/a>:<strong><br \/>\n<\/strong><\/h2>\n<ul>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2020\/06\/Ph.D.-Record-of-Progress.docx\" target=\"_blank\" rel=\"noopener noreferrer\">PhD record of progress<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2017\/05\/DOCTORAL-COMPREHENSIVE-EXAMINATION-Part-I-grading-form-revised-June-2016.docx\" target=\"_blank\" rel=\"noopener noreferrer\">Doctoral comprehensive examination form<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2020\/06\/Request-For-HMSC-Core-Faculty-Membership.docx\" target=\"_blank\" rel=\"noopener noreferrer\">Request for HMSC core faculty membership<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2020\/06\/Research-Experience-Form.docx\" target=\"_blank\" rel=\"noopener noreferrer\">Research Experience form<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2020\/06\/Teaching-Experience-Form.docx\" target=\"_blank\" rel=\"noopener noreferrer\">Teaching Experience form<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2020\/06\/Optional-Course-Of-Study-Outline.docx\">Optional Course of Study Outline<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2020\/06\/Optional-Student_Mentor-Exam-Timeline-Worksheet.docx\">Optional Student\/Mentor Exam Timeline Worksheet<\/a><\/li>\n<\/ul>\n<hr \/>\n<h2><a href=\"http:\/\/gradschool.unc.edu\/academics\/resources\/forms.html\">UNC Graduate School<\/a> Forms<\/h2>\n<ul>\n<li><a href=\"https:\/\/gradschool.unc.edu\/academics\/resources\/forms.html#doctoral\">Report of doctoral committee composition<\/a><\/li>\n<li><a href=\"https:\/\/gradschool.unc.edu\/academics\/resources\/forms.html#doctoral\">Report of approved dissertation project<\/a><\/li>\n<li><a href=\"https:\/\/gradschool.unc.edu\/academics\/resources\/forms.html#doctoral\">Doctoral exam report<\/a><\/li>\n<\/ul>\n<hr \/>\n<h2>Additional Forms:<\/h2>\n<ul>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2019\/04\/Dissertation-DEFENSE-Announcement-final.docx\" rel=\"noopener\">Dissertation <strong>Defense<\/strong> Announcement<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2019\/04\/Dissertation-PROPOSAL-Announcement-final.docx\" rel=\"noopener\">Dissertation <strong>Proposal<\/strong> Announcement<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2018\/05\/Independent-study-tracking-form-template.docx\" target=\"_blank\" rel=\"noopener noreferrer\">Independent Study Tracking Form<\/a><\/li>\n<li><a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-content\/uploads\/sites\/1442\/2018\/05\/Independent-study-grading-rubric.docx\" target=\"_blank\" rel=\"noopener noreferrer\">Independent Study Grading Rubric<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Recurring Forms Form Initially Completed By: Reviewed By: Target Deadline: Submit To: Contract Letter Faculty Student Summer\/Early Fall &#8211; Annually HMSC Director Plan of Study Student and Mentor Each Semester (As needed) N\/A IDP Student Mentor Late Spring\/Early Fall &#8211; Annually No Submission Required Program and Mentor Evaluations Student Mentor (optional) Spring &#8211; Annually HMSC &hellip; <a href=\"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/forms\/\" aria-label=\"Read more about Forms\">Read more<\/a><\/p>\n","protected":false},"author":111958,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"layout":"","cellInformation":"","apiCallInformation":"","footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-357","page","type-page","status-publish","hentry","odd"],"acf":[],"_links_to":[],"_links_to_target":[],"_links":{"self":[{"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/pages\/357","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/users\/111958"}],"replies":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/comments?post=357"}],"version-history":[{"count":2,"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/pages\/357\/revisions"}],"predecessor-version":[{"id":2867,"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/pages\/357\/revisions\/2867"}],"wp:attachment":[{"href":"https:\/\/www.med.unc.edu\/healthsciences\/hmsc\/wp-json\/wp\/v2\/media?parent=357"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}