Forms - Medical Students


UT MSPE Format (click on the hyperlink to view the MSPE format)


Visiting Student Application Form for International Medical Students (Note:  Allopathic and Osteopathic Medical Students should submit forms via VSAS.) -- Click on the link to the right to download the pdf form.  You can complete information online, print, and secure signatures from your school's officials (Dean's Office) and have them affix the school seal.


For students interested in electives in the following departments, complete the online short forms by clicking the Left-Hand Links and submitting them directly to the department online before applying through VSAS or the pdf form above:


      Emergency Medicine
      Family Medicine
      Internal Medicine
      Orthopaedic Surgery


Housing Request

        Click here if you need to request housing for your student rotation - Complete and submit the
         form online.

                  Housing Assginment Guidelines

                  First priority is to 3rd year UT students

                  Second priority is to 4th year UT students


Since we frequently have more than 28 students, it helps if students from the Chattanooga area stay with friends or family to maximize available housing. 


*UT Students who intend to complete most of their Clerkship and Elective rotations in Chattanooga should obtain their own housing at their expense. 


*If students have friends or family in the Chattanooga area, we expect them to utilize this option.  This will help to provide student housing for those who do not have any other option.


*We do not begin reviewing the student housing roster until thirty (30) days prior to the beginning of the rotation.  If we see any sign of housing limitations, we will notify you IMMEDIATELY.   If you do not hear back from Courtney Orloski immediately,  you will receive a "Welcome" email approximately 7-10 days prior to the beginning of the rotation, which will include detailed check-in and Orientation instructions.


Please complete all the forms listed below -- 


As soon as you  have scheduled and been approved for a medical student rotation in Chattanooga (via the UT Student Scheduling System), please complete the following forms:



  1. Medical Student Photo - Please email a jpg photo of yourself to before beginning your rotation.
  2. Medical Student Biographical Information - Complete and submit the form online as soon as your rotation is scheduled and approved.  
  3. Erlanger Medical Library Usage Agreement - Medical Students - Given to you at orientation to sign. 
  4. Erlanger Information Confidentiality Agreement  - Given to you at orientation.
  5. Orientation handbook 2016-2017- Click on this link to view detailed instructions that will be discussed at orientation on your first day of the rotation.
If you are staying in the Hayden Place Apartments, please complete the following:
  1. Apartment Review:  Check-In Form - Given at orientation
  2. Combine No Smoking and Damage Policy- Given at orientation
  3. Apartment Checkout Review:  Complete this when you leave and check out of the apartments at Hayden Place. 

At the end of each block, we ask that you complete an evaluation form to provide feedback about the rotation and overall Chattanooga experience: 

  1.  Evaluation Form
At the end of your rotations in Chattanooga, you must complete the following and return your photo ID, pager, meal card, Erlanger Security access card and parking pass used in your car, as well as complete:
  1. Evaluation Form
  2. Clearance Form




Revised:  02/07/2019

UT College of Medicine Chattanooga     960 East Third Street, Suite 100     Chattanooga, TN 37403     (800)947-7823, ext 6956

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