Urology Education Verification

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Cost: $75 fee is assessed per verification

Return Time: Training verifications generally take 7-10 business days to complete. If a request is more urgent, please reach out via email below.

Prerequisites: A signed release form is required from the physician whose education is being verified.

Send it one of the following ways:

Fax: 713-798-5553
Email: uroeducation@bcm.edu
Mail to:

Baylor College of Medicine
Department of Urology
Attn: Aqsa Khan
7200 Cambridge St., 10th Floor, Suite 10C
Houston, TX 77030

Requester First Name

Requester Last Name

Requester Email

Phone Number

Person for whom you are requesting verification

Residency: Did the physician complete Urology Residency at Baylor College of Medicine?

Yes

Residency Year of Completion

Residency Years of Training

Fellowship: Did the physician complete a Fellowship in the Urology sub-specialty at Baylor College of Medicine?

Yes

Fellowship sub-specialty

Fellowship Year of Completion

Payment For

Payment Amount

$75.00 (USD)

Email Address (for payment contact)

Phone Number (for payment contact)

Card Number

Name on Card

Card Expiration

Security Code (CVV)

Zip or Postal Code

Note