Student Medical Instrument Verification Form

If you are experiencing problem submitting this form, please email SAATech@utsouthwestern.edu
Submission Deadline: 1 July 2025

* Name:

Student ID (if known):

* Email:

Medical Instrument Verification

* By checking on this box and submitting this form, By checking on this box and submitting this form, I acknowledge that I own (or have ordered) a stethoscope, diagnostic kit, a reflex hammer, and a 128Hz tuning fork.

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