Request for Internal Medicine Internship and Residency Postgraduate Training Verification

Fee Notification

$100.00 for each form.

Requests will only be processed with payment and must include: Full name at the time of training, date of birth, and with an original/wet or notarized digital signature authorization. A DocuSign release/consent is also acceptable.

To pay by credit card, please call the cashiers office at 904-244-3500 and reference Account# 16014 for payment of training verification. Ask for a receipt number AND the approval code and email both to lorna.matos@jax.ufl.edu. Once payment is processed, the verification may be completed within 5-10 business days based on the availability of the Program Director for signature. Please allow sufficient time for processing.