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Online Registration

Prior to completing your initial student registration, you must submit a HIPAA Student Confidentiality Agreement to UAMS College of Public Health, Office of Student Services, 4301 West Markham, #820, Little Rock, Arkansas 72205. You will not be able to to receive your grades or request a transcript until an original copy is received. (Note: No faxes or photocopies will be accepted. If you have completed this form in a previous semester, there is no need to submit a new one.)

Name:   (as it appears on your application)
Phone:
Select Program:
DrPH MPH MHSA
Certificate Non-Degree    
Area of Interest:
Preferred Class
Class 1:
Class 2:
Class 3:
Class 4:
Class 5:
Alternate Class
Class 1:
Class 2:
Class 3:

I hereby authorize UAMS to release my personal information to be inserted into the Student Directory and as outlined by the Family Educational Rights and Privacy Act (FERPA). Please see the 2008-2010 COPH Student Handbook, page 24 for further explanation.

Yes    No

By submitting this form, I hereby agree that once I am enrolled in any College of Public Health class, it is my responsibility to receive official notices and other pertinent information through the UAMS Exchange electronic mail system.

If you are an employee of the University of Arkansas System, please click here for the UA Employee Discount form.  If you are an employee of the Arkansas Department of Health, the Arkansas Department of Environmental Quality, The Minority Health Commission, or the Tobacco Settlement Commission, please contact the Office of Student Services at (501) 526-6746 to inquire about Student Discounts.

To help us get in touch with you, please provide us with your e-mail address. You will NOT receive a registration confirmation if this information is not provided.

E-mail:  





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