Lab Coats Order Form
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Last Name *
First Name *
Middle Name
Credentials *
Please choose only degrees that you actually have earned (or will earn by the time you begin your residency) that you want to appear on your white coat.
Required
Please be aware that, per policy, we credential physicians according to the degree conferred by their medical school. For example, D.O. for Doctor of Osteopathy, M.D., Doctor of Medicine, M.B.B.S., Bachelor of Medicine, Bachelor of Surgery, etc. While all of these degrees use the prefix “Dr.” the credentials you earned are the ones that must be used for identification purposes. We will not substitute “MD” for a trainee who has earned an “MBBS” degree.
Training Program *
Reason For Ordering New Coats? *
Coat Selection
You will be given 2 embroidered coats with your name and program printed on them.  Please see the links below for detailed information about coat styles and sizing (depending on your browser you may have to copy/paste the URLs):

   

KP13WH - Women's Coat

KT33WH - Women's Coat With Sewn-In Belt

Women's Style and Sizing Chart: https://med.virginia.edu/gme/coat-styles-womens

   

KT34WH - Men's Coat With Sewn-In Belt

KP14WH - Men's Coat:

Men's Style and Sizing Chart: https://med.virginia.edu/gme/coat-styles-men
Coat Style *
Coat Size *
Please be careful to choose a size within the available range for the coat you've selected above.
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