HP Transcript Authorization Form

Academic advising by Health Professions Director, Candice Eisenhauer. Completing this form authorizes the director the ability to view your academic record on Wheaton's DegreeWorks for advising purposes. If you have any questions, email the Health Professions office.

The office provides helpful resources for those interested in a pre-health track or health care career goal.

Completing this form will enable students access to:

Academic advising by Health Professions Director, Candice Eisenhauer. Completing this form authorizes the director the ability to view your academic record on Wheaton's DegreeWorks for advising purposes. If you have any questions, email the Health Professions office.
Upcoming pre-health events and workshops on and off campus
Weekly emails from the Health Professions Director
Health Professions information page providing links to resources such as:
- Experiential Learning Opportunities
- Exploring various pre-health areas
- Summer Experiences
- Highlights and clips from virtual meetings of health professionals
- Test Prep Resources

Full Name

First NameLast Name

Wheaton Student ID#

Wheaton College email address

Typically: first.last@my.wheaton.edu

Cell Phone

Home City and State

Anticipated Graduation Month and Year

Healthcare Interest

(Medicine, Nursing, Physical Therapy, etc.)

I am a transfer student

School transferred from

Major

(Declared or Undeclared)

Please list activities you are in/plan to be in at Wheaton (ex: Football Team, Gospel Choir, etc.)

Any comments you would like to share or questions you would like to ask:

Favorite snack food or candy (optional):

I hereby give Candice Eisenhauer, Health Professions Director, authorization to be my pre-health professions advisor. In so doing, I give her permission to access and view my academic record. She has permission to access my academic record to assist in advising for a potential major change and/or my interest in pursuing health profession school.

Signature

By selecting the "I Accept" checkbox, you consent to the legally binding terms and conditions of this Agreement and your acceptance of them. You further agree that by typing your name below, you are electronically signing this agreement, and this electronic signature will have the same effect as a handwritten signature for the purposes of validity, enforceability, and admissibility.

Printed Name

Today's Date

Welcome to the Health Professions office