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University Medicine Smoker/NonSmoker Affidavit As communicated in the 2013 Wellness Program announcement, all employees and their spouse/domestic partner who have coverage under the University Medicine
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How to fill out university medicine smokernon-smoker affidavit

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How to fill out a university medicine smokernon-smoker affidavit:

01
Obtain the affidavit form: The first step is to obtain the official university medicine smokernon-smoker affidavit form. This form can typically be found on the university's official website or obtained from the admissions office.
02
Read the instructions: Before filling out the affidavit, carefully read through the instructions provided. Familiarize yourself with the purpose of the affidavit and any specific requirements or guidelines mentioned.
03
Provide personal information: Start by filling in your personal information accurately. This may include your full name, student ID number, contact information, and any other details required by the form.
04
Indicate smoking status: The main purpose of the affidavit is to confirm whether you are a smoker or a non-smoker. Tick the appropriate box or provide the necessary information to indicate your smoking status.
05
Sign and date the affidavit: At the end of the form, you will typically find a section for your signature and date. Make sure to sign the affidavit using your legal signature, ensuring it matches the name provided earlier. Write down the current date as well.
06
Submit the completed affidavit: Once you have accurately completed the affidavit form, make a copy for your records and submit the original to the designated authority. This could be the admissions office, health center, or any other department specified by the university.

Who needs a university medicine smokernon-smoker affidavit?

01
Prospective medical students: University medicine smokernon-smoker affidavits are commonly required by medical schools or universities offering medicine programs. Prospective students who are applying to these institutions may need to submit this affidavit as part of the application process.
02
Health institutions: In some cases, health institutions or hospitals where clinical rotations are held may also require individuals to provide a smokernon-smoker affidavit. This helps in ensuring a smoke-free environment and may be necessary for the safety and well-being of patients.
03
Research or clinical trials: Some research studies or clinical trials related to medicine or healthcare may require participants to disclose their smoking status. A smokernon-smoker affidavit can serve as a means of obtaining this information in a legal and confidential manner.
Remember, the specific requirements for the smokernon-smoker affidavit may vary depending on the university or institution. It is always advisable to carefully review the instructions provided with the affidavit and reach out to relevant authorities for any clarifications.
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University medicine smokernon-smoker affidavit is a document where individuals declare whether they are a smoker or non-smoker.
All individuals affiliated with the university medicine program are required to file the smokernon-smoker affidavit.
The affidavit can be filled out by providing personal information and indicating whether the individual is a smoker or non-smoker.
The purpose of the affidavit is to gather information on the smoking status of individuals within the university medicine program.
The information reported must include personal details and the individual's smoking status.
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