Dual Degree Authorization Form

Instructions

For all new degree programs, Academic Advising Dean approval is required in order for the dual degree to be approved by the School of Medicine Registrar's Office. Please complete the below authorization form after consultation with your Academic Advising Dean. The Advising Dean will review and approve.

Review your academic record in MEP and list any outstanding deficiencies below for the Committee on Performance, Professionalism and Promotion (CP3) approval, if applicable. The authorization form will be routed to the Registrar's Office for final review.

If you have questions about the dual degree policy or form, please contact the SoM Registrar’s Office at medregistrar@stanford.edu or your Advising Dean.

Student First Name

Student Last Name

SUID

8-digit University ID number

Student Stanford Email

Location of Dual Degree

University or college at which the dual degree will be awarded. If this is an internal degree, list Stanford. If external, list the name of the school.

Dual Degree Program

Ex. Epidemiology, Public Health, Business, etc.

Degree Type

Ex. MS, PhD, MBA, JD, etc.

Proposed Start Date of Degree

Proposed Graduation Date of Degree

Academic Advising Dean

Academic Standing

I am in good academic standing at the School of Medicine at the time of submission, meaning I have no outstanding deficiencies in the MD curriculum.

Yes

I have consulted with my Academic Advising Dean about my intention to add a dual degree, my academic plan, and any outstanding deficiencies (if applicable).

Send me a copy of my responses

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