Students who are interested in pursuing pre-dentistry, pre-pharmacy, pre-medicine, and/or pre-veterinary medicine at Cleveland State University are asked to complete this brief intake form. The information that you provide here will help us to understand your interests and background so that we may better serve you.

* 1. Please complete the fields below.

* 2. Please indicate below your program of interest. You may select multiple programs.

* 3. How did you hear about our program?

* 4. Please provide the following information regarding your high school academic record.

* 5. Please provide the following information regarding your college/university academic record. Information from up to three institutions may be entered.

So that we may provide you with the best service, please submit unofficial transcripts for all colleges/universities previously attended BEFORE attending an information session or scheduling an academic advising appointment.

* 6. Is there additional information about you, your educational background, or your career interests that was not addressed elsewhere on this intake form but that you feel it is important to share with us?