Medical H.E.L.P. Application (Sensitive information required for Marshall University ID Office)

Application Form (Medical H.E.L.P.)

If you experience any issues with this form not submitting, please contact Robbie Ashworth at (304)696-5834 or

    •  Section I: General Information
  • Current Address

  • Permanent Address (Leave blank if same as current address)

    •  Section II: MCAT

    •  Section III: Medical School History

    •  Section IV: Academic and Accommodations History

    •  Section V: Diagnostic Testing Information

    •  Section VI: Additional Information

  • Parent's Address
  • *Contact Diana Porter, HELP Program Business Manager, to arrange $500 down payment: 304.696.5220 or

    *Any other questions, contact Robert Ashworth at 304.696.5834 or

    **All fields written in gray are optional