LAMA Form

LAMA Form
Name

First NameLast Name
Email
example@example.com
Phone Number

Country CodeArea CodePhone Number
Citizenship
Academic status
University
If your university is not listed please type it here
Graduation date

DayMonthYear
Date
Services
USMLE step1 price
USMLE step2 CK price
Malpractice insurance price
RTR price
Visa Assistance calculations
Research price
Rotation price
Discount
How many rotations (LORs) needed?
Rotation 1
Rotation 1 type:
If other Please specify
Rotation 1 duration (per weeks)
Rotation 1 start date

DayMonthYear
Date
Rotation 1 Price
Rotation 1 Malpractice
Rotation 1 Calculations
Rotation 2
Rotation 2 type:
If other Please specify
Rotation 2 duration (per weeks)
Rotation 2 start date

DayMonthYear
Date
Rotation 2 Price
Rotation 2 Malpractice
Rotation 2 Calculations
Rotation 3
Rotation 3 type:
If other Please specify
Rotation 3 duration (per weeks)
Rotation 3 start date

DayMonthYear
Date
Rotation 3 Price
Rotation 3 Malpractice
Rotation 3 Calculations
Rotation 4
Rotation 4 type:
If other Please specify
Rotation 4 duration (per weeks)
Rotation 4 start date

DayMonthYear
Date
Rotation 4 Price
Rotation 4 Malpractice
Rotation 4 Calculations
Rotation 5
Rotation 5 type:
If other Please specify
Rotation 5 duration (per weeks)
Rotation 5 start date

DayMonthYear
Date
Rotation 5 Price
Rotation 5 Malpractice
Rotation 5 Calculations
Rotation 6
Rotation 6 type:
If other Please specify
Rotation 6 duration (per weeks)
Rotation 6 start date

DayMonthYear
Date
Rotation 6 Price
Rotation 6 Malpractice
Rotation 6 Calculations
USMLE Step1 Course Date

MonthDayYear
Date
USMLE Step1 duration (per weeks)
USMLE Step1 Calculations
USMLE Step2 CK Course Date

MonthDayYear
Date
USMLE Step2 CK duration (per weeks)
USMLE Step2 CK Calculations
Housing start date

MonthDayYear
Date
Add your notes
Should be Empty: