Pre-Professional Health Visit Day

Thank you for taking the next step to schedule a visit to UW-Eau Claire to see if we’re the right fit for you—we look forward to welcoming you to campus! In order to provide the best day possible, we ask that you fill out the form below. We know the form is long; however, these questions will allow us to personalize your visit and deliver the service you deserve. It will also help us personalize future communication you receive about UW-Eau Claire.

Legal First Name

Preferred First Name

Last Name

Student Email Address

Family Email Address

Mobile Phone Number

We share important messages and updates with students through text messaging. If you do not want to receive these messages, please check this box.

Secondary Phone Number (if different than mobile phone provided above)

Birthdate

Mailing Address

Country
Street
City
Region
Postal Code

Select the student type that best represents you:

Current high school student

High school graduate with no college coursework

College student looking to transfer

College student or college graduate looking to pursue a Master's or Doctorate degree

Bio/Demo Information

Gender (As reported on birth certificate)

Gender Identity

Academic Information

High School

High School CEEB

College

College CEEB

What term do you plan to start at UW-Eau Claire?

Interests

Primary academic interest:

Secondary academic interest:

Visit Details

How many visitors will be attending the visit with you? (Note: You will not be able to exceed 3 guests through the registration process. However, if you have more than 3 guests, please still bring them to the visit, as we're happy to accommodate you.) If you're looking to bring a group to campus, please register through our Group Registration form.

If you have friends attending the visit with you that are interested in UW-Eau Claire, please list their first and last name(s).

Please indicate any accommodations you will need for your visit. You may be contacted if we need further information to help us best serve you.

Wheelchair

Interpreter

What type of interpreter do you need? Note: We are only able to provide the following interpreter accommodations.