Residency and Fellowship Program Training Verification

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For Alumni: Residency and Fellowship Program Training Verification

The Department of Neurology offers training verification for fellows and residents who completed their medical education at McGovern Medical School within the Department of Neurology at The University of Texas Health Science Center at Houston. To help cover the administrative costs associated with credentialing current trainees, a fee is required when requesting a training verification. Please refer to the information below for additional details.

All verification requests must provide:

1. UTHealth Neurology Department Survey Submission: https://uthealth.questionpro.com/t/AdCkyZ8eAz (external link)

2. Consent to Release of Information and Release of Liability Form signed by the UTHealth alum or equivalent

3. Verification Request Form

4. Mailed payment- Fees and Mailing address are determined by the type of verification requested. Please note that completed verifications will be submitted upon receipt of payment. Instructions on where to mail payment located in survey.

• $75.00 – Standard Verification includes:
o Name of Trainee
o Training Program and Specialty
o Dates of Training
o Training Status (i.e., Completed, In Progress, Incomplete)
o Unusual Circumstances
o Signature of the Senior Program Manager or Senior Fellowship Coordinator

• $125.00 –Non-Standard Organizational Form:
o Specific Privileges or Procedure Training
o Performance Evaluations
o Program Director Signature