XAVIER UNIVERSITY OF LOUISIANA
Premedical Office
1 Drexel Drive•Box 120
New Orleans, LA 70125-1098
Email: xupremed@yahoo.com Website: www.xula.edu/premed
Phone: (504) 520-7437 Fax: (504) 520-7923
Date:
_________________
To:
_____________________________________________
Evaluator
From:
_____________________________________________
Student Name
_______________________________________________
Major
_____________________________________________
Student Contact Phone #
______________________________________________
Student Email Address
Thank you for agreeing to write my evaluation for ________________________________________(e.g. medical school, dental
school, research program, summer program, etc.). I respectfully request that the evaluation be submitted to the Premedical
Office (Box 120) by the following date: ____________________*.
*SPECIAL EVALUATION REQUIREMENTS FOR STUDENTS APPLYING TO
LSU-SHREVEPORT MEDICAL SCHOOL!!!
All letters of recommendations (i.e. evaluations) must be:
·Dated (no earlier than May of the year that the student submits his/her application to medical school);
·Signed by the letter writer; and
·Must be on letterhead with contact information. If letterhead is not available, the letter must contain the letter writer’s address
and/or email address along with all contact information.
!YES , I verify that the medical school evaluation that you write on my behalf will be used to support my application to
LSU-Shreveport Medical School and therefore CANNOT be dated prior to May 1st of the year that I will submit my medical
school application. (For example, if a student applies for entry in 2017, the letter CANNOT be dated prior to May 1, 2016.)
Course(s) taken with you and grade received (if not currently enrolled):
COURSE
GRADE Semester/Year Enrolled
To assist you with writing this letter of evaluation, I have attached the following items:
1) Personal Statement,
2) Post-Secondary Experiences Form, and
3) OPTIONAL: SMDEP Recommendation Form for students who are applying to SMDEP and no other program.
Please write the evaluation on department letterhead (OR complete the SMDEP Recommendation Form if I have informed
you that I am ONLY applying to the Summer Medical and Dental Education Program; see note on page 2) and forward it
directly to XU’s Premedical Office (Box 120) where it will be placed in my file.
I (check one)
_____________waive __________do NOT waive my right to see the evaluation. NOTE: It is highly
recommended that the student waive his/her right to see the letter of evaluation.
___________________________________________________________
Student Signature
______________
Date
Please send the evaluation to the Premedical Office, NCF 108 (Campus Box 120) and keep this form for your records.
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Special notes from the Premedical Office to faculty/staff evaluator:
•We do not use of a specific evaluation form for students applying to summer/research programs or medical, dental, etc.
school. Instead, each faculty should write the letter in standard format in the word processor he/she normally uses and then
print it on letterhead stationery. EXCEPTION: Students applying ONLY to the Summer Medical and Dental
Education Program (SMDEP) for the upcoming summer OR students whose schools or programs REQUIRE the
completion of a school or program-specific form. Also, there may be schools or programs that require completion of
an online evaluation, in which the evaluator (not the PM Office) must complete the online form.
•Because a large number of Freshman and Sophomore Premeds apply to the Summer Medical and Dental Education Program
(SMDEP), it is okay to use the SMDEP Recommendation Form in lieu of an evaluation written on department letterhead if
the student indicates that this is the ONLY program that he/she is applying to for the upcoming summer.
•If this letter of evaluation is written for medical school and will be used to support the student’s application to LSUShreveport School of Medicine, the letter CANNOT be dated prior to May 1st of the year in which the student will submit
his/her medical school application (e.g. if the student is applying in 2016 for entry in 2017, the letter of evaluation cannot be
dated prior to May 1, 2016).
•We advise students to waive their right to see letters of evaluation because medical, dental, etc. schools view such letters to
be more reliable.
•In writing your letter of evaluation, please note that medical, dental, etc. schools look at faculty
letters primarily to assess…
o a student’s cooperative nature,
o leadership abilities,
o professional demeanor,
o compassion,
o empathy,
o communication skills,
o determination,
o social interest, and
o maturity.
Therefore, comments you can make about these qualities are more useful than statements about the
student’s academic potential.
•Medical School Evaluations: Please review the Association of American Medical College’s (AAMC) “Letters of Evaluation
Guidelines” at https://www.aamc.org/initiatives/admissionsinitiative/letters/. Please note that while the AAMC allows
evaluators to submit evaluations directly to their application service by mail or direct upload, we encourage students to have
all professional school evaluations filed in the Premedical Office so they can request to have evaluations transmitted to
application services or individual schools as needed.
•Letters should include statements of how well and in what capacity you know the student as well as your overall evaluation
of him/her.
•If you would like to view a SAMPLE letter of evaluation, please send a message to xupremed@yahoo.com so the sample
evaluation can be emailed to you.
•Letters of evaluation may be hand-delivered to the Premedical Office (NCF 108), mailed (Campus Box 120), or emailed
(scanned copy with signature to xupremed@yahoo.com).
•In order to be considered valid, the letter must be dated and signed by the letter writer.
EVALUATION WAIVER: Most schools and programs will only accept letters of evaluation that the student has waived access
to; as a result, the student must have a signed/dated “Evaluation Waiver Form” on file in the Premedical Office indicating that
he/she has waived the right to see any letters of evaluation that have been filed in the PM Office on his/her behalf. The student
is also encouraged to waive the right to access the letter on page one of this “Faculty Evaluation Cover Letter” so that you, the
letter writer, can retain waiver status for your files. Please note that the Premedical Office keeps all evaluations in a secure
location that students cannot access. If a student requests to see his/her evaluation, we tell him/her that we will NOT grant such
a request but instead will return the letter to the evaluator who can decide whether or not to allow the student to see the
evaluation or to destroy it.
MODIFYING FILED EVALUATIONS: If any changes need to be made to a letter of evaluation once it is filed in the
Premedical Office, it is the responsibility of the letter writer to make the change him/herself. It is ILLEGAL for anyone except
the letter writer to modify the evaluation in any way, including changing the date that appears on the letter of evaluation.
ONLINE EVALUATION FORMS: If a school, program, or application service REQUIRES the completion of an online or
electronic evaluation or reference form, the evaluation must be completed directly by the evaluator, not the Premedical Office. Please
contact the student who requested the letter of evaluation directly for instructions on submitting electronic evaluation forms.
Please send the evaluation to the Premedical Office, NCF 108 (Campus Box 120) and keep this form for your records.
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