Family Medicine Year 4 Electives Request Form

Please fill out the below form to request year 4 electives in Family Medicine.

  • This form is only open to Western students. If you are a visiting student, please visit the Visiting Student Elective website.
  • This form will ask for specific blocks. If you plan on switching your FM block, please put the block you are requesting, or make a note that the block may change.
  • Once your form is submitted, please allow 4-6 weeks for confirmation by email from the Program Coordinator.
  • A copy of your submission will be sent to you by email for your records.
  • Please do not include requests for Windsor

Please Note: The electives request form will become available July 9, 2021 at 9:00am

After July 9, 2021 at 9:00am Click Here to Submit your Year 4 Elective Request