{"id":823,"date":"2019-09-20T09:51:00","date_gmt":"2019-09-20T13:51:00","guid":{"rendered":"https:\/\/geiselmed2.dartmouth.edu\/oaa\/?page_id=823"},"modified":"2026-02-16T13:36:33","modified_gmt":"2026-02-16T18:36:33","slug":"templates","status":"publish","type":"page","link":"https:\/\/geiselmed.dartmouth.edu\/ofa\/templates\/","title":{"rendered":"Forms and Templates"},"content":{"rendered":"<h2>Forms<\/h2>\n<p><strong><a href=\"https:\/\/geiselmed.dartmouth.edu\/faculty\/voluntary-faculty-form\/\" target=\"_blank\" rel=\"noopener\">Voluntary Faculty (Clinical and Adjunct Faculty Lines) Request Form<\/a><\/strong><br \/>\nUse this form to request an appointment or reappointment in Clinical, Adjunct or Honorary Faculty Lines at the Geisel School of Medicine at Dartmouth. Visit the\u00a0<a href=\"https:\/\/geiselmed.dartmouth.edu\/oaa\/document\/appointments-promotions-titles\/\" target=\"_blank\" rel=\"noopener\">Academic Appointments, Promotions, and Titles<\/a>\u00a0<span style=\"color: #444444\">website for criteria related to these two faculty lines. All items must be completed by the applicant and reviewed by the Department Chair\/Institute Director at Geisel before submitting this form to the Office of Faculty Affairs. \u00a0Approval of the candidate\u2019s application and credentials by the Department Chair\/Institute Director is\u00a0required\u00a0for the voluntary faculty appointment to be granted.<\/span><\/p>\n<p><b><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/forms\/nfa_request\/\">Non-Faculty Academic (NFA) Appointment\/Promotion Request<\/a><\/b><br \/>\nUse this form to request Dean of Faculty Affairs approval for an appointment or promotion to a Non-Faculty Academic rank (Research Associate, Research Fellow, Research Scientist, Distinguished Fellow). Visit the\u00a0<a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/document\/appointments-promotions-titles\/part-ii-academic-titles\/non-faculty-academic-nfa-titles-and-promotion\/\">Non-Faculty Academic (NFA) Titles and Promotion<\/a>\u00a0page for criteria related to these appointments. Please allow a 14 business day turnaround time for review.<\/p>\n<p><b><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/forms\/emeritus_request\/\">Request for Consideration of Emerit Status<\/a><\/b><br \/>\nUse this form to initiate a request for Emerit status for a retiring faculty member. Visit the <a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/document\/appointments-promotions-titles\/part-ii-academic-titles\/emeritus-faculty\/\">Emerit Faculty<\/a> page for criteria related to this status. The process commences with the departmental and\/or program Chair providing written recommendation of emerit status to the Dean of Geisel School of Medicine. This recommendation, supported by the candidate\u2019s curriculum vitae, should clearly and specifically document the academic accomplishments and the value the individual has provided to the missions of the Medical School. The Dean, should they concur, will then make their own to the Provost. The change to emerit status must be approved by the Provost, the President, and the Dartmouth College Board of Trustees.<\/p>\n<p><b><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/forms\/cv_request\/\">Request for CV Review for Appointment or Promotion<\/a><\/b><br \/>\nUse this form to request Dean of Faculty Affairs review of a candidate\u2019s credentials for appointment or promotion. Visit the\u00a0<a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/document\/appointments-promotions-titles\/part-ii-academic-titles\/emeritus-faculty\/\">Academic Appointments, Promotions, and Titles<\/a>\u00a0page for criteria related to academic titles, lines, and tracks. Please allow a 14 business day turnaround time for review.<\/p>\n<p><strong><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2023\/02\/Geisel-Application-for-Faculty-Development-Travel_-Feb-2023.pdf\">Geisel Application for Faculty Development Travel_ Feb 2023<\/a><\/strong><\/p>\n<h2>Templates<\/h2>\n<ul>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2020\/02\/Advocacy-Portfolio-Template-for-Pediatrics-2020.docx\" target=\"_blank\" rel=\"noopener\">Advocacy Portfolio Template<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2021\/02\/Educator-Portfolio-Template-Example-2.12.21.docx\">Educator\u2019s Portfolio Template<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2021\/05\/GeiselFacultyCVInstructions05.07.21.docx\">Geisel CV Instructions for Faculty<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2021\/05\/GeiselCVInstructionsResearchScientists05.07.21.docx\">Geisel CV Instructions for Research Scientists<\/a><\/li>\n<\/ul>\n<p><b>Faculty Template Offer Letters<\/b><\/p>\n<ul>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2024\/02\/Template_Lecturer_02_13_2024.docx\">Template_Lecturer_02_13_2024<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2024\/02\/Template_Non-Tenure_Faculty_Line_02_13_2024.docx\">Template_Non-Tenure_Faculty_Line_02_13_2024<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2024\/02\/Template_Tenure_Faculty_Line_02_13_2024.docx\">Template_Tenure_Faculty_Line_02_13_2024<\/a><\/li>\n<\/ul>\n<p><b>Non-Faculty Academic Template Letters (Dartmouth College or DC Visiting)<\/b><\/p>\n<ul>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2026\/02\/Template_Research_Associate_A_02.16.2026.docx\">Template_Research_Associate_A_02.16.2026<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2026\/02\/Template-Research-Associate-B-or-C_02_13_2026.docx\">Template-Research-Associate-B-or-C_02_13_2026<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2024\/01\/Template_Research_Associate_Nonpaid_Clinical_01_31_2024.docx\">Template_Research_Associate_Nonpaid_Clinical_01_31_2024<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2024\/11\/Template_Research_Scientist_11_20_2024.docx\">Template_Research_Scientist_11_20_2024<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2024\/01\/Template_Research_Associate_Nonpaid_Clinical_01_31_2024.docx\">Template_Research_Associate_Nonpaid_Clinical_01_31_2024<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2026\/02\/Template_Research_Fellow_Template_Offer_Letter_02_13_2026.docx\">Template_Research_Fellow_Template_Offer_Letter_02_13_2026<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2023\/04\/Template_Visiting_NFA_Faculty_Non-Paid_04_17_2023.docx\">Template_Visiting_NFA_Faculty_Non-Paid_04_17_2023<\/a><\/li>\n<\/ul>\n<p><b>Terms of Appointment Statements (Faculty and NFA; D-H, WRJ-VAMC)<\/b><\/p>\n<ul>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Research_Scientist_Clinical_7_25.docx\">Terms_of_Appointment_Research_Scientist_Clinical_7_25<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Research_Associate_Clinical_07.2025.docx\">Terms_of_Appointment_Research_Associate_Clinical_07.2025<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Statement_Instructor_7_25.docx\">Terms_of_Appointment_Statement_Instructor_7_25<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Statement_Instructor_for_Fellow_7_25.docx\">Terms_of_Appointment_Statement_Instructor_for_Fellow_7_25<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Statement_Clinical_Fellow_7_25.docx\">Terms_of_Appointment_Statement_Clinical_Fellow_7_25<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Statement_Assistant_Professor_7_25.docx\">Terms_of_Appointment_Statement_Assistant_Professor_7_25<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Statement_Associate_Professor_or_Professor_7_25.docx\">Terms_of_Appointment_Statement_Associate_Professor_or_Professor_7_25<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/08\/Terms_of_Appointment_Statement_VA_07_25.docx\">Terms_of_Appointment_Statement_VA_07_25<\/a><\/li>\n<\/ul>\n<p><strong>APT Templates<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2021\/05\/APT-Committee-Reviewer-Template-04-23-2021.docx\">APT Committee Reviewer Template<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2021\/01\/APT-External-Reviewer-Template.docx\">External Reviewer Template<\/a><\/li>\n<li><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2021\/09\/Learner-Evaluation-Form-9.7.2021.pdf\" target=\"_blank\" rel=\"noopener\">Learner Evaluation Form<\/a><\/li>\n<\/ul>\n<p><strong>Visa Extension Letter Template<\/strong><\/p>\n<p><a href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-content\/uploads\/sites\/56\/2025\/04\/VISA-Extension-Template-4.23.25.docx\">Visa Extension Template<\/a><\/p>\n<p><b>Staff Template Offer Letters<br \/>\n<\/b>Staff offer templates can be found on the <a href=\"https:\/\/geiselmed.dartmouth.edu\/hr\/protected-resources\/templates\/\">Geisel HR site<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Forms Voluntary Faculty (Clinical and Adjunct Faculty Lines) Request Form Use this form to request an appointment or reappointment in Clinical, Adjunct or Honorary Faculty Lines at the Geisel School of Medicine at Dartmouth. Visit the\u00a0Academic Appointments, Promotions, and Titles\u00a0website for criteria related to these two faculty lines. All items [\u2026] <\/p>\n<div class=\"clear\"><\/div>\n<p><a class=\"more_link clearfix\" href=\"https:\/\/geiselmed.dartmouth.edu\/ofa\/templates\/\" rel=\"nofollow\">Read More<\/a><\/p>\n","protected":false},"author":163,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-823","page","type-page","status-publish","hentry","author-163"],"jetpack_shortlink":"https:\/\/wp.me\/PbswBh-dh","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/pages\/823","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/users\/163"}],"replies":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/comments?post=823"}],"version-history":[{"count":110,"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/pages\/823\/revisions"}],"predecessor-version":[{"id":5265,"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/pages\/823\/revisions\/5265"}],"wp:attachment":[{"href":"https:\/\/geiselmed.dartmouth.edu\/ofa\/wp-json\/wp\/v2\/media?parent=823"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}