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Request Official Student Records

Use this form to request official student records including letter of academic standing, MSPE, transcripts, certified photocopies of diploma, or replacement of original diploma. 

Instructions: 

There is a $5.00 fee per transcript (no charge for currently enrolled students).  There is a $15.00 fee for replacement of original diploma.  Payment must accompany request form.  Please make checks payable to SIU School of Medicine. 

PLEASE RETURN COMPLETED FORM VIA MAIL, FAX, OR EMAIL TO:

Karla Hehner, Registrar - registrar@siumed.edu

Phone: 217-545-0890 Fax: 217-545-5538

SIU-SOM, Office of Student Affairs, RM 3080
P.O. Box 19624
Springfield, IL 62794-9624
 

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