Forms

Access your enrollment verification letters and unofficial transcripts on the MYDGSOM Student Portal.

Document Request Forms

• Chair's Letter Request (RRMC) (WORD)
• Dean's Letter of Recommendation (PDF)
• Document Request (Current Students) (PDF)
• Jury Duty Letter Request (PDF)
• Alumni Document Requests

Graduation Forms

• Change of Graduation Date (PDF)
• Diploma Agent Authorization Form (PDF)

Elective Scheduling Forms

• Away Elective Checklist (PDF)
• Away Elective Application (PDF)
• Late Drop Petition (Less Than 30 Days) (PDF)

Leave of Absence (LOA), Time Off, and Return Forms

• Academic Leave of Absence Request (Qualtrics)
• Clearance to Return to Curriculum/Clerkship (PDF)
• Leave of Absence Extension Request (Qualtrics)
• Medical Leave of Absence (MLOA) (Qualtrics)

• Personal Leave of Absence Request (Qualtrics)
• Return from Leave of Absence (Qualtrics)"Time Off" from Curriculum Request (PDF)
• Withdrawal Request (PDF)

Name and Address Change Forms

• Change of Address (MyUCLA)
• Lived Name Request Form (PDF)
• Name Change or Correction (Current Students) (PDF)

Resources and document requests.

Academic calendars, schedules, and events.

Student portal for all your curricular needs.

Policies, procedures, and guidelines.

Student portal for your courses.

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Student Affairs Office

The DGSOM Student Affairs Office staff are telecommuting. Our staff is available via email or phone call to support your curricular needs.

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885 Tiverton Drive
Los Angeles, CA 90095

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