MUSM Registrar's Office Request Form - Former Students Only
 
Instructions
This request form can only be used by alumni who were enrolled in the School of Medicine at Mercer University. Requests are usually completed within 1 to 3 business days. During peak times, please allow a minimum of one (1) week for processing.
If you need to request an official electronic transcript, please order via the Parchment Portal - http://www.parchment.com/u/registration/33871/account. Transcripts ordered via Parchment are $3.00 per copy and $28.00 for rush orders.
Please note that only unofficial transcripts may be emailed from the Registrar's Office.
Last Name
First Name
MUID
Maiden Name
Address
City
State
Zip Code
Phone Number
Email
Program of Study






MD only
Graduation Date
Current Practice or Training Location
Special Instructions: Briefly describe any special instructions below. Do not restate instructions stated on certification forms from third parties.
Please provide complete mailing and/or email address for delivery of requested documents.
Upload all files associated with your request

 

By submitting this request, I am granting permission for Mercer University School of Medicine Registrar Office to release information to third parties.
Signature (please type)
Date