Name Change Request

If your name changes while you are in medical school, you must notify the Registrar’s Office. Simply fill out the Name Change Affidavit below and submit it along with a copy of a legal name-change document, such as a marriage license, driver’s license, Social Security card, passport or other document.  Any questions, please contact the Registrar’s office.

Name Change Request Form

Brendan McCarthy
University of Kentucky College of Medicine
800 Rose Street, MN-102C
Lexington, KY 40536-0298
Phone: (859) 218-1638
Fax: (859) 323-4094