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Student Forms

See the full collection of SMHS student forms by category below.

  • Phase 1 (Pre-Clinical) Excused Absence Request

  • Budget Appeal Request
    • Away Clinical Rotation Expenses
    • Residency Application & Interview Expenses
    • USMLE Exam Expenses
    • Other Expenses in Excess of Standard Cost of Attendance
  • Outside Aid Reporting Form
  • RuralMed Application
  • U.S. Department of Health & Human Service Loan Applications
    • Loan for Disadvantaged Students
    • Primary Care Loan
    • Non-Filer Form

  • Release of Information (ROI)
  • Graduating Medical Student Degree Verification Request

Below are the Campus & Clerkship Administrators for whom have a legitimate educational interest in Clinical Course Schedules

Bismarck (Southwest) Campus:

  • Jodi Rathjen
  • Susanna Warner
  • Deb West

Fargo (Southeast) Campus:

  • Kristi Hofer
  • Sarah Julsrud

Grand Forks (Northeast) Campus:

  • Stacie Klegstad
  • Carla Sanden

Minot (Northwest) Campus:

  • Jodee Nielsen
  • Aimee Smith

Emergency Medicine

  • Jodi Rathjen

Family Medicine

  • Melissa Gardner
  • Stephanie Boltz

Internal Medicine

  • Carla Mosser
  • Kathryn Camburn

Neurology

  • Vacant

Obstetrics/Gynecology

  • Tracey Steffes

Pathology

  • Stacie Klegstad

Pediatrics

  • Brianne Melicher

Psychiatry

  • Danielle Cellucci

Radiology

  • Jodi Rathjen

Surgery

  • Marlys Peterson
Student Affairs & Admissions
SMHS Room W101
1301 N Columbia Rd
Grand Forks ND 58202-9037
P 701.777.4221
F 701.777.4942
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    School of Medicine & Health Sciences

    1301 N Columbia Rd Stop 9037
    Grand Forks, ND 58202-9037

    701.777.2514

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