Record Request Form

This form must be completed and submitted to the Office of the Registrar in order to obtain copies of education records on file:

Only the student or the party with signed consent from the student in accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA) may request records for that student.
Only copies of records will be provided, not the actual records themselves (reissued diplomas may be requested via the Reissued Diploma form and require a duplication and special handling fee).
While it is standard for institutions to charge for record requests, such as transcripts, RVU does not; however, expedited mail requests and reissued diplomas will require an additional fee. Current students can print unofficial transcripts via MyVista.

A separate form must be completed for each recipient. However, multiple documents for the same recipient can be submitted on the same form.

STUDENT INFORMATION

Student name:*

First MI Last

Program:*

DO
MSBS
MMS
PA

Campus:*

CO
Montana
UT

Class or graduation year:*

Birth date:*

Student ID or last 4 digits of SSN:*

Phone:*

Email:*

Mailing address:*

Street Address City State ZIP / Postal Code

RECORD DETAILS

Select all that apply and enter the quantity needed for each.

Document*

Note:
Enrollment Verification (EV) – The EV contains dates for this academic year and expected graduation date, stating the student is in good academic standing and has no clinical or evaluation details.

Letter of Good Standing (LOGS) - This detailed document must come from the student’s Clinical Rotations Coordinator.

Enrollment Verification (EV)
Official Transcript
Dean's Letter/MSPE
Diploma Copy
Background/Health Records
Form to be completed/signed by the registrar
Military request
Other

Please specify for Other:*

Quantity of official transcript:*

Quantity of enrollment verification (EV):*

Quantity of dean's letter/MSPE:*

Quantity of diploma copy:*

Quantity of background/health records:*

Quantity of form to be completed/signed by registrar:*

Quantity of other:*

Please upload the form here:*

Drop files here or

Max. file size: 10 MB.

Comments:

DELIVERY METHOD

Select the delivery method and provide the address if different from above. A separate form must be completed for each recipient.

Method:*

Mail
Email
Upload to website
Pick up from registrar

Mailing address:*

Same as above
Other address

Specify other address:*

Street Address Address Line 2 City State ZIP / Postal Code

Email address:*

Same as above

Upload to website:*

VSLO
ERAS

Proof of identification required (e.g. driver’s license, passport, student ID)

ACKNOWLEDGEMENT

I am the student requesting my own records for myself or for another.
I am the holder of signed consent from the student in accordance with FERPA.

Please attach signed consent document.*

Drop files here or

Max. file size: 10 MB.

Name:*

Signature:*

Date:*

After submitting, there is no need to follow up with a second form or by email/phone, as doing so will push your request out and cause delay of processing.