MEDEX Supplemental Application Instructions

Review the MEDEX Northwest PA Program requirements for both the Bachelor’s and Master’s program prior to filling out the supplemental application. There is a separate supplemental application for each degree option. Fill in all applicable information completely and accurately. Please enter information directly into the on-line application form that is available on our web site, double check the application to make sure the information is correct and, submit the application electronically. Print a copy of your Supplemental Application and send any supporting documents directly to MEDEX Northwest. Please make sure to keep a copy of the supporting documents you send as we will not copy your information and return it to you.

Tips to successfully completing your supplemental application on line.

Begin your CASPA application before starting your MEDEX supplemental application. You will be required to enter your CASPA id# on your MEDEX application.
Enter only the 11 digit CASPA id# in the space provided. If you submit a supplemental application without the CASPA id#, or if it is entered incorrectly, your application will not go through the initial screening or file review process.
Completely read the instructions before you begin the application.
Read the technical standards and understand the contents before starting your application.
REMEMBER: When filling out your MEDEX application do not use the back arrow button. If you make a mistake, please hit the reset button. This will reset the entire form. This is a tab through form and information in the writable fields can be edited. Please, do not go back to other pages of the website while you are filling out the application. This, too, will reset the form and erase what you have already entered.
Double check the information entered into the MEDEX supplemental application before submitting to ensure that
we receive the data you intended to send.
Print a copy of the application for your records before clicking the submit button.

If you have a different or abbreviated first or last name you would like us to use, please put it in parenthesis in the Name field. It will help us to get to know you better. Enter an e-mail address were we can reach you. E-mail is the best way for you to communicate with CASPA and MEDEX if you have questions regarding your application status or the application procedure. MEDEX will communicate with you via e-mail during the admissions process. Check your e-mail regularly
and make sure MEDEX is in your e-mail account address book so group e-mails are not automatically dumped into a junk mail or trash folder. Please e-mail your questions to us at medex@u.washington.edu. If you have questions for CASPA, please email CASPA directly at CaspaInfo@caspaonline.org

Keep in mind that the contact information you give us is the information that will be used to reach you. Please make sure that your information is accurate and kept current. If, during the application process, your address, telephone number, or e-mail address changes, please email or call the MEDEX office with the new information as soon as possible.

Indicate your status as a new applicant, this means you have not applied to the MEDEX Northwest program within the last five years (since 2004). Check the re-applicant box. if you have applied to the MEDEX program within the last five years. If you speak and read any language other than English, we would like to know.

MEDEX will have four training sites for the 2010 entering class. Applicants will select their site based on the degree offered and whether they meet the prerequisite for the degree option at that site. Each site is also influenced by its location in Washington or Alaska and it’s urban vs. rural location. Please take the time to explore the site references, local resources and determine whether you meet the academic prerequisites. Applicants can only apply to be in either
the bachelor’s or master’s sites… not both. Students will not be allowed to transfer from one degree option to the other. Please fill out the appropriate supplemental application based on the degree option available and locations choice.

Because the MEDEX supplemental application is an on-line form your actual signature will not be required. By clicking the submit button you acknowledge that the information provided in this application is true, accurate and complete. You
are acknowledging that you understand the role of a Physician Assistant student in the MEDEX Northwest program, understand the Technical Standards, that you understand the Comprehensive Criminal History Background check information and, that you are confirming the degree option you are applying for. By submitting this application you
are authorizing MEDEX Northwest to process this application and verifying all information provided.

If any information provided in the supplemental application or CASPA application is found to be incomplete, inaccurate
or falsified in any way your application will not be forwarded to the file review process with MEDEX Northwest. If information provided in either application is found to be incomplete or false after being accepted to MEDEX your standing in the program may be jeopardized.

All applicants with prior military experience are required to complete the Military section of the MEDEX Supplemental application. All former service members are required to submit the DD214 to complete the supplemental application.
If you are an active duty service member or current reservist you are required to complete this section of the MEDEX Supplemental Application and provide proof of current service.

Please submit all documentation of training and coursework completed through the military directly to MEDEX.
(A DD214 FORM IS REQUIRED if you are no longer in active or reserve status.) If your separation date is after
being accepted to the MEDEX program, submit a copy of the DD214 as soon as it becomes available to you.

Download the Technical Standards to read and make sure that you understand the contents of this document before beginning the on line application.

MEDEX Northwest will now require all newly admitted students to apply for a background check using the same system the University of Washington School of Medicine has adopted. Background checks will be required prior to beginning each year of training and will cost the student approximately $75 each year. Make sure you read and understand the Criminal History Background check information. More information about the Criminal Background check will be provided if accepted to the MEDEX program.

VII. PERSONAL STATEMENT

Copy and paste or, type your personal statement directly in the space provide in the application. Keep in mind that MEDEX will have your CASPA application and CASPA personal statement–we do not want a duplication of the CASPA statement. Please limit this personal statement to no more 1000 words.

For applicants applying to the Bachelor’s of Clinical Health Services degree option, please answer the following
in your general personal statement:

For applicants applying to the Master’s of Clinical Health Services degree option, please answer the following thee questions in your general personal statement:

Why did you select MEDEX Northwest and what can the MEDEX Program teach you?
How do you think having a Master’s degree will effect your future options?
What are the biggest challenges you face by returning to school and what will you contribute to your MEDEX classmates?

For re-applicants only:

If have applied to the MEDEX program within the last five years you are considered a re-applicant. The re-applicant personal statement must be completed in addition to the general personal statement. In the space provide on the application form explain what you have done to strengthen your application. Please limit the re-applicant statement
to 500 words

For Military applicants:

If you are an applicant with military experience you are required to fill out the Military experience section of the application designed to capture the details specific to your military training. In addition to this a personal statement
must be completed and will supplement the general personal statement and re-applicant statement (if applicable).
It is important for us to understand this part of your background since about 25-30% of our students come with prior military experience. Please limit the military statement to 500 words

MEDEX would prefer references from physicians or mid-level provider (i.e.; PA or ARNP). If your CASPA references don’t already include a reference from a physician or mid-level provider you may submit one (1) additional reference (beyond the 3 that CASPA requires) to be sent directly to MEDEX This optional reference must be from a physician
(MD, DO) or a mid-level provider (PA, NP). Your references should attest to your clinical capabilities.

The MEDEX Reference forms are accessible from the MEDEX website and must be downloaded to fill out. MEDEX cannot receive electronic references. Please note that the references are composed of two parts. Part I of the form must to be filled out and signed by you and your reference, Part II is the rating sheet, and Part III is the letter that must accompany the form. The reference must be completed and sealed in an envelope with the reference’s signature
across the sealed flap in order to be considered valid. Opened references will not be accepted. Reference must be received by October 1st, 2009 for 2010 admissions and must be mailed separately.

Submit your application before the final deadline of October 1st 2009 and send all supporting documents
directly to:

MEDEX Northwest
ATTN: Admissions
4311 11th Ave NE Suite 200
Campus Box # 354980
Seattle, WA 98105 - 4608