Confidential Applicant Reference Form

Deadline: Februrary 1, 2023 (by 11:59 PM)

Each applicant to the BScPA Physician Assistant Professional Degree Program is required to secure three referees to complete an online Applicant Reference Form. It is the responsibility of the candidate to secure referees who meet the requirements listed below. Should a referee not meet these requirements, the reference will be deemed unacceptable, and therefore the application will be incomplete and may not be considered.

Please note: The program will send the applicant reference form directly to the referees listed on the supplemental application form.

  • Only three references (the first three received) will be accepted

  • My referees have known me for at least 3 months

  • My referees have the knowledge of my performance as a health care provider

  • My referees are in a position to make reasonable statements concerning my character, personal qualities, and clinical abilities/professional attitudes

  • My referees have supervised me in a clinical/research setting OR My referees have not supervised me in a clinical /research setting because I have worked independently with no direct supervision. My referees are professional colleagues or in a capacity to comment on my professional/clinical skills (e.g. a physician who referred patients to my services)

  • I have not provided health care services to my referees

  • I have not received health care services from my referees

  • My referees are not a member of my family nor a personal friend

Instructions for Applicant

  1. The program will send the reference forms directly to your referees to complete and submit on your behalf. The forms will be sent to referees listed on the supplemental application. Please be sure to let your referees know that we will not accept any documents (including referee forms) after February 1st.

  2. Ensure that your referees complete the form by the deadline date.

  3. Candidates will be able to verify that the BScPA Program received the completed forms from their referees after approximately two weeks, via the admissions portal at Referees will not receive a confirmation of receipt from the program.

Please note: References must use a professional email address. Gmail and Hotmail will not be accepted.

Instructions for the Referee

  1. Complete and submit the Applicant Reference Form provided to you by the program.

  2. Ensure you complete the form by the deadline date.

  3. Ensure you use a professional email address; Gmail and hotmail addresses will not be accepted.

  4. Once you submit the completed form; you are not able to make any edits.

Referees will not receive a confirmation of receipt from the program.

Questions about the form? Please email:

Should an applicant progress to the vMMI interview, we will be performing random reference audits.