Gurnick Academy of Medical Arts
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  • MRI Technology Program
  • Phlebotomy Technician Program
  • Physical Therapist Assistant Program - AS Degree
  • Psychiatric Technician Program
  • Radiologic Technology Program (X-Ray Program)
  • Ultrasound Technology Program
  • Vocational Nurse Program (VN Program)
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  • IV Therapy/Blood Withdrawal Course
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  • San Mateo Campus
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San Mateo
(650) 685-6616
Main campus
Concord
(925) 687-9555
Branch campuses
Fresno
(559) 222-1903
Modesto
(209) 521-1821
Questions? Call free 1-877-GURNICK
Home›Forms
Questions? Call free 1-877-GURNICK

Forms

  • Enrollment Application/Registration Form

    The Gurnick Academy of Medical Arts Enrollment Application/Registration Form may be filled out with an admission advisor or brought to a scheduled appointment with the appropriate admission advisor already completed.

    Download
  • Transcript Request Form

    This form must be sent to the following address or fax number:

    • Mail to: 2121 S. El Camino Real, Building C-200 San Mateo, CA 94403.
    • Fax to: (888) 812-4257
    Download
  • Preparticipation Physical Exam Form

    Each student before starting any program or its clinical component must provide an attestation from his or her family physician certifying of the absence of physical and/or mental and/or contagious disorders. This form cannot be substituted for any other.

    Download
  • Leave of Absence Form

    Should a student’s circumstances be such that a leave of absence is needed, the student must submit an application for a leave of absence to the School Director or designated official for approval.

    Download
  • Test Accomodation Form

    This Form must be returned to the designated Program Official. Please inquire with your Admission Advisor who the designated Program Official is. We will not accept any incomplete forms.

    Please submit the Test Accommodation Request Form a minimum two weeks prior to the test date.  If done later than two weeks there might not be an opportunity to aid you with the test accommodation as there might not be enough time to find an accommodation for you.

    Download
  • Vocational Nurse Graduate Survey

    Please use according to the Refundable Statistical Data Recover (RSDR) Fee Policy which can be found here.

    Download
  • Ultrasound Technology Program Graduate Survey

    Please use according to the Refundable Statistical Data Recover (RSDR) Fee Policy which can be found here.

    Download
  • MRI Technology Program Graduate Survey

    Please use according to the Refundable Statistical Data Recover (RSDR) Fee Policy which can be found here.

    Download
  • Phlebotomy Course Completion Survey

    Please use according to the Refundable Statistical Data Recover (RSDR) Fee Policy which can be found here.

    Download
  • FERPA form

    Click on the link to read more about Student's Right to Privacy Policy.

    Download
  • Change of Name Form

    Please use according to Change of Name Policy which can be found here.

    Download
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© Gurnick Academy of Medical Arts
  • San Mateo2121 South El Camino Real, Building C-200, CA 94403
  • Concord1401 Willow Pass Road, Suite 450, CA 94520
  • Fresno2984 North Maroa Avenue, CA 93704
  • Modesto4712 Stoddard Road, Suite 200, CA 95356