In order to complete the application process, please print three copies of the evaluation form and have professors or employers submit them to the following address:
Program of Medical Laboratory Science , Vanderbilt University Medical Center 4605 TVC 1301 Medical Center Drive, Nashville, TN 37232-5310
If you have any questions during this process, please e-mail us at the address below:
Vanderbilt University Medical Center
Program of Medical Laboratory Science
Applicant's name ___________________________ SSN___________________
To the applicant: please sign and date one of the following statements.
1. I wish to have access to this letter and I understand that under the Family Education Rights to Privacy Act of 1974, 20 U.S.C.A. Par. 1323 g(a) (1) and P.L. 397 of 1978, I have the right to read this recommendation
2. I wish this letter to be confidential and I hereby waive any and all access rights granted me by the above laws to this recommendation.
TO THE EVALUATOR: Please rank the applicant based on the following scale: Standards to be used in ranking. 4-excellent, outstanding; 3- above average; 2- average; 1-below average; NA- no basis for judgement.
|Knowledge and Interest in Medical Lab Science|
|Ability to deal with difficult situations|
|Level of commitment to complete a task/goal|
|Ability to work with others|
|Sensitivity to others|
|Ability to analyze a problem or situation|
|Problem solving skills|
|Ability to communicate with others|
|Ability to follow through|
|Confidence/Awareness level of strengths and weaknesses|
PLEASE ADD ANY SPECIAL COMMENTS:
SUMMARY: How would you rank this individual as a candidate for admission?
|Above average||Below average|
Evaluator's name (please print) _________________________________________
Evaluator's contact information _________________________________________
email (not required)__________________________________________
Please indicate how long you have known the applicant and in what capacity.
Please return to:
Program of Medical Laboratory Science , Vanderbilt University Medical Center, Room 4605 TVC
1301 Medical Center Drive, Nashville, TN 37232-5310