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Online Application Form

Please complete this online application form and click the “submit” box at the bottom to send. For more information, call or email Aditya Sharma, MBBS, Fellowship Program Director at as8ah@virginia.edu

Vascular Medicine Fellowship Application

  • PERSONAL DATA

  • Accepted file types: jpg, jpeg, png, gif.
    Please add a photo of yourself here.
  • EDUCATIONAL DATA

  • Drop files here or
    Accepted file types: doc, jpg, gif, pdf, png, Max. file size: 100 MB.
    • ADDITIONAL INFORMATION

    • The University of Virginia's Non-Discrimination Act Policy

      The University of Virginia (“UVA”) does not discriminate on the basis of age, color, disability, gender identity or expression, marital status, military status (which includes active duty service members, reserve service members, and dependents), national or ethnic origin, political affiliation, pregnancy (including childbirth and related conditions), race, religion, sex, sexual orientation, veteran status, and family medical or genetic information, in its programs and activities as required by Title IX of the Education Amendments of 1972, Americans with Disabilities Act of 1990, as amended, Section 504 of the Rehabilitation Act of 1973, Titles VI and VII of the Civil Rights Act of 1964, Age Discrimination Act of 1975, Governor’s Executive Order Number One (2018), and other applicable statutes and University policies. UVA prohibits sexual and gender-based harassment, including sexual assault, and other forms of interpersonal violence. Individuals, including UVA students and employees, and participants in UVA’s programs or activities, may be entitled to reasonable accommodations or modifications for a disability. The following person has been designated to handle inquiries regarding the Americans with Disabilities Act, Rehabilitation Act, and related statutes and regulations: ADA Coordinator, Office for Equal Opportunity and Civil Rights, P.O. Box 400144, Charlottesville, VA 22903, (434) 924-3200, ADACoordinator@virginia.edu. A Deputy ADA Coordinator has also been designated to assist the ADA Coordinator: P.O. Box 400144, Charlottesville, VA 22903, (434) 924-3200, ADACoordinator@virginia.edu. The following person has been designated to handle inquiries regarding the non-discrimination policies: Associate Vice President, Office for Equal Opportunity and Civil Rights, P.O. Box 400219, (434) 924-3200, UVAEOCR@virginia.edu. The following person has been designated to serve as the overall coordinator for purposes of Title IX compliance: Assistant Vice President & Title IX Coordinator, (434) 297-7988, TitleIXCoordinator@virginia.edu. A Deputy Title IX Coordinator has also been designated to assist the Title IX Coordinator: (434) 297-7988, TitleIXCoordinator@virginia.edu. Complaints of discrimination, harassment and other forms of interpersonal violence, and retaliation may be submitted to the UVA Office for Equal Opportunity and Civil Rights (“EOCR”). Complaint resolution procedures, which include information on how to submit a complaint, are available on EOCR’s website. Complaints may also be filed with external agencies, such as the U.S. Department of Education Office for Civil Rights, U.S. Equal Employment Opportunity Commission, Commonwealth of Virginia Office of Civil Rights, and the Virginia Department of Human Resource Management. Revised October 2023
    • Max. file size: 100 MB.
    • Max. file size: 100 MB.
    • Max. file size: 100 MB.