Newly Added Form: Student Request for HPAC Committee Letter.Please download form and complete before emailing it with your completed application to Lisa Hansinger at Please click here.  


Students must submit the following documents to their HPAC file by FEBRUARY 15, 2021 of the year they are seeking review.
You must register first, letting us know your intent to apply for an HPAC Review using this Google Form. Following the form submission, you will be emailed a unique link to a shared Google folder for all of your documents to be submitted through.  The following items (see each item below) will need to be downloaded, completed and re-uploaded to your unique Google form.  There are several forms that require YOUR SIGNATURE.  These forms will need to be printed, signed and scanned before uploading.  Please keep the name of the form the same but add your last name.  This will allow us to easily identify the form and student who submitted it.

 1.  Unofficial Transcripts (Class History) from Degreeworks

  • The HPAC Committee will need to review your unofficial transcripts.  Please download and print a copy to upload to your Google Form.  You can find your Class History by clicking on the three little dots in the upper right hand corner of Degreeworks once you are logged in.  The dots are right next to the printer and email icons.  From the drop down, choose "Class History" and then print and scan that document.

2. Academic Honesty and Policy Violation Release Form

  • This form is an opportunity to voluntarily provide information about any University policy that you were deemed to have violated during your time at Saint Joseph’s University or at any other college or university that you have attended.  Each professional application you submit will also ask you to provide this information and a background check will be run upon your acceptance to verify this information.  This form will be kept confidential with only the HPAC Committee Members having access to the information you provide.  Please note that this form will require YOUR SIGNATURE.

3. FERPA Release for Community Standards

  • This form is required in order to obtain records from SJU Community Standards regarding any policy violation that has occurred.  This form requires YOUR SIGNATURE.

4. Evaluator List 

  • Complete the Evaluator List to indicate who you are requesting Letters of Evaluation from.  You will need to upload this to your Google form so we know who to expect Letters of Evaluation from on your behalf.
  • The Health Professions Advisor will communicate with the faculty to share the appropriate uploading process for their feedback form and Letter of Recommendation.
  • Science majors should request three (3) letters from Science/Math faculty (at least one (1) from the major department) and one (1) from a Humanities/Social Science professor.
  • Non-science majors should request two (2) letters from Science/Math faculty and two (2) from Humanities/Social Science professors with at least one (1) from the major department.
  • Choose professors who know you well and who will give you a strong recommendation.  Recommenders should speak to your academic, professional or personal development and competencies.

5. Faculty Letter of Evaluation and Instructions 

  • Email these instructions and evaluation/feedback form to your recommenders for ease of completion since the evaluation/feedback form is a fillable pdf.  Recommenders will then complete the evaluation/feedback form, attach your letter of evaluation and then upload it to a Google form designated for their use (this link is listed on the instruction sheet).
  • Supply each professor with the Faculty Letter of Evaluation and Instructions, an unofficial copy of your transcript, and personal statement by January 31 at the latest so that the faculty can submit their completed letter by the HPAC deadline of February 15.
  • Please request that the faculty recommender upload your letter by the deadline of February 15

6. Student Biographical Questionnaire

(Please note: this form has been updated as of 1/15/21 to reflect minimal changes.  Please compare content with the Sample SBQ below.)

  • This is an outline of the content we need to review your HPAC file.  Please type the information on a Word Document and upload that to your Google Form.
  • Please CLICK HERE for a sample of a Student Biographical Questionnaire

7.  Personal Statement

  • There is no "form" for the personal statement, however, there is a place to upload it on your Google Form.  It should be neatly typed as a Word Document.
  • This should be an honest, serious, well-written essay about you, your goals, your motivation to enter a health career, and why you think you are an appropriate candidate for professional school. Highlight specific examples from your background. You can use this essay later on your applications. Although there is no specific size limit for HPAC purposes, limit your character count to 5300 characters for medical school essays as that is the limit for the medical school application services, and 4500 for other health professions as that is the limit on other applications (dental, optometry, etc).

8. A recent photograph of yourself.

  • Feel free to take a PROFESSIONAL selfie to upload for your file. Your google form will have a specific place to upload this photo.