Dc medical license character reference form 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name and location at the top of the form. Ensure this matches the setting listed on the application’s chronological page.
3. Clearly print or type the name of the applicant in the designated field.
4. In Item #1, provide details about your service with the applicant, including their role and dates of service. If applicable, indicate the number of months of postgraduate training awarded.
5. Evaluate the applicant by checking appropriate boxes for professional knowledge, clinical judgment, relationship with patients, ethical conduct, interest in work, and communication ability.
6. Answer whether the applicant has faced any disciplinary actions. If yes, provide explanations on a separate sheet.
7. Indicate your recommendation level by checking one of the options provided and add any necessary explanations.
8. Provide comments on notable strengths and weaknesses of the applicant in the space provided.
9. Finally, indicate how your report is based (personal observation, general impression, etc.), sign and date the form before submission.

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