Please complete a brief personal statement of 5,000 characters or fewer addressing the question below: What do you hope to achieve from your experience as a NEOMED student?

Please complete a brief personal statement of 5,000 characters or fewer addressing the question below: What do you hope to achieve from your experience as a NEOMED student?

1. Describe your NEOMED legacy relationship. “Legacy Relationship” is defined as parents or siblings of NEOMED alumni, current NEOMED students, or parents or siblings serving as NEOMED faculty (either course instructors or clinical faculty). (Optional/If this applies to you) (100 characters)

2. If you answered “yes” to any of the preceding questions, explain here. Be sure to indicate the level of offense (e.g. misdemeanor, felony, etc.) (Optional/If this applies to you) (5000 characters)

a. Please explain any traffic violation(s) here: (Optional/If this applies to you) (5000 characters)

b. Please explain any academic violation(s) here: (Optional/If this applies to you) (5000 characters)

c. Please explain your dismissal (from a medical education program) here: (Optional/If this applies to you) (250 characters)

3. Please complete a brief personal statement of 5,000 characters or fewer addressing the question below:

What do you hope to achieve from your experience as a NEOMED student?

1) NEOMED Personal Statement Please complete a brief personal statement of 5,000 characters or fewer addressing the question below: What do you hope to achieve from your experience as a NEOMED student?

**Optional explainers**:

1) (Optional) Describe your NEOMED legacy relationship. “Legacy Relationship” is defined as parents or siblings of NEOMED alumni, current NEOMED students, or parents or siblings serving as NEOMED faculty (either course instructors or clinical faculty). (100 characters)

2) yes/no

a) Have you been convicted of, or pleaded guilty or no contest to, any criminal offense in a court of law?

b) Have you ever been convicted of a crime related to the manufacture of, or possession with intent to manufacture or deliver a controlled substance?

c) Have you ever been found in a dependency action (RCW 13.34.040), domestic relations proceeding (Title 26 RCW), disciplinary board hearing or protection proceeding (Chapter 74.34 RCW), to have sexually assaulted or exploited, sexually or physically abused a minor or developmentally disabled person OR to have financially exploited or abused a vulnerable adult?

d) Have you ever been judged liable for civil monetary penalties for conduct related to the delivery of services, supplies, or other participation in Medicare/Medicaid or any other state or federal healthcare program?

e) Have you ever been excluded from providing services or supplies under Medicare/Medicaid, or any other federal funded healthcare program? If you answered “yes” to any of the preceding questions, explain here. Be sure to indicate the level of offense (e.g. misdemeanor, felony, etc.) (5000 characters)

3) Please explain any traffic violation(s) here (5000 characters)

4) Have you ever been found responsible for any academic violation(s) while enrolled in college/university level coursework (after high school) (e.g. plagiarism, academic dishonesty. etc.)? Please explain any academic violation(s) here: (5000 characters)

5) Have you ever been dismissed from a medical education program? Please explain your academic dismissal here (250 characters)