Packet Request Form

Please complete the form below and we will send you a packet of information. Or, you may call Michayla Williams at 314-286-1655. She may also be reached by email at [email protected].

* First Name:

* Last Name:

* Address Line 1:

Address Line 2:

* City:

* State:

* Zip:

* Email:

* Phone:

* Degree(s) of Interest:

MSOTOTDPhD

Do you have any connection to Washington University (i.e., a family member, advisor, recommender, etc.)?

* How did you find out about us?

* Are you currently enrolled in school?

High schoolUndergraduateGraduate

If currently enrolled, please list school & location:

If not currently enrolled, what is your highest degree?

High SchoolUndergraduateGraduatePostgraduate

Thank you for your interest in the Program in Occupational Therapy at Washington University School of Medicine in St. Louis.