Please fill out this form and click "Submit". Once the submission has been reviewed, an invoice with payment instructions (3-5 business days) will be sent to your email address unless an applicable fee waiver is selected.
Fee per training program request is $50.
Fees will be waived for:
Post Graduate Forms/State Board Forms:
Please allow 10-15 business days from the time we receive payment for the completion of requests. Additional time may be required for dates prior to 1990 and for Post Graduate/State Board Forms that require the Program Director Signature.
**Dental and Pharmacy requests should not be submitted via this form but should instead be submitted directly to the program**
Your health information, right at your fingertips. Select MyUPMC to access your UPMC health information. For patients of UPMC-affiliated doctors in Central Pa, select UPMC Central Pa Portal. Patients of UPMC Cole should select the UPMC Cole Connect Patient Portal.