Inpatient & MROC/MIOC Block Schedule Requests: 2017-2018
This is the form to submit individual day off requests for Internal Medicine inpatient rotations. If you have more than one request, please submit multiple times.

To ensure your request is appropriate, please refer to the Internal Medicine Service Rules before submitting.

Last Name *
Your answer
First Name *
Your answer
University of Chicago Email *
Your answer
PGY Level *
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