Required Forms and Information for Accepted SURP Students

These  forms  are required ONLY after you have been accepted to the SURP program. Once you've been accepted, the department will contact you with information regarding the submission of these documents.

The following four documents (required immunizations, waiver of Release, Liability and Media Release and proof of health insurance) must be completed and returned  (by mail, email, scan  or fax) to Recruitment and Student Engagement by May 1st.   Please note that your acceptance to SURP is contingent upon the completion of these forms.

Recruitment and Student Engagement
984275 Nebraska Center
Omaha, NE 68198-4275
Phone:  402-559-3809
Fax:  402-559-3819
Contact Email:

Click on the forms below to link to the required forms.

1. Required Immunization Form

*The form indicates to send your health records to Student Health, please DO NOT SEND TO STUDENT HEALTH.  You’ll submit this immunization form to Recruitment and Student Engagement at the address listed above along with your other required forms.

For questions or concerns about immunization requirements please contact:

Student Health at 402-559-5158 or 402-559-5691.
Fax: 402-559-8118

NOTE:  The Hepatitis B vaccination is a 3 dose series that can take up to 7 months to complete. Students participating in SURP program must document receiving 2 of the 3 immunizations prior to May 1st

2. Waiver Release of Liability Form

3. Media Release Form

4. Proof of Health Insurance – please send a copy of your health insurance card.


Additional Program Information:

Compliance Training
All students are REQUIRED to attend compliance training EACH YEAR.

Recruitment and Student Engagement Certificate of Participation in the Luncheon Seminars
The Office of Recruitment and Student Engagement coordinates a luncheon seminar series every Tuesday at noon. Different researchers from campus will be sharing their research. Any summer student who attends 7 out of the 8 luncheon seminars will receive a certificate of participation from the Office of Recruitment and Student Engagement.

Other Events
During the summer, SURP students will be invited to join other undergraduate students on campus for social activities, and optional professional examination practice testing.

Student Health
Be aware that SURP students are not considered UNMC students through Student Health.  If you would like to be seen at the clinic, you’ll need to go in as a regular patient.  If no appointments are available for the day, you’ll be referred to the ER if necessary.