Thompson Advising - Experience. Knowledge. Results.

Expert Medical School Admission Consulting and Post-Bac Program Admission Consulting

Client Information Form

To begin the advising process, please fill out and submit the Client Information Form. Be sure to fill in all required fields otherwise the form will not be submitted. You will know the form went through successfully when you receive a copy of it. Please list activities only once in the form; do not duplicate activities. Once I have received the form I will be in touch to schedule a videoconference. In the meantime, if you have any questions please do not hesitate to contact me at liza@thompsonadvising.com or by phone at 410-292-5219. I look forward to working with you.

Best regards,
Liza Thompson

Name *
Address *
City *
State *
Zip *
Email address *
Birthdate *
Cell phone *
Preferred method of contact *:
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Preferred Pronouns
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College or university *
Major/s *
Year of Graduation *
SAT or ACT score. Please list your total SAT or composite ACT score, with individual scores in each section also listed.
If there are any gaps in time during your undergraduate education (leaves of absence, etc.) please explain here.

Please enter your MCAT score below, including individual section scores, along with the composite score and percentiles.

Date taken:
Chemical and Physical
Percentile
CARS
Percentile
Biological/Biochemical
Percentile
Psychological/Social
Percentile
Composite Score
Percentile
Date taken:
Chemical and Physical
Percentile
CARS
Percentile
Biological/Biochemical
Percentile
Psychological/Social
Percentile
Composite Score
Percentile
If you have not taken the MCAT please indicate when you plan to take it. If unknown, please leave this space blank.
Intended year of medical school enrollment *
If you have previously applied to medical school please list the dates of the application cycle(s).

GPAs: Please list below your GPA in each area indicated.

Science/Math (Biology, Chemistry, Physics, and Math) GPA
Non-science GPA
Cumulative GPA

Please send an electronic college or university transcript(s) to liza@thompsonadvising.com.

If you have graduated from college, what have you been doing since you graduated? Please provide one or two paragraphs summarizing your activities since college graduation.
Please attach your resume to this form. (We accept DOCX, DOC, RTF, TXT, PDF up to 1 MB)
Optionally, please attach a digital photo; it will only be used to associate your face with your written materials. I like having an image of someone I am reading about through their credentials and essays. (We accept JPG, PNG, GIF, BMP, TIFF, EPS up to 2 MB)

College Experiences

Please list your most significant activities in college, including any employment, along with dates you were involved in these activities and the total number of hours for each activity (not the hours per week). *:

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If you were involved in more than five activities, please provide the title of the activity, the dates involved, and a short description of each below.
Of the activities listed above, which was the most meaningful? Please provide one or two paragraphs summarizing the activity and the reason(s) it meant a great deal to you. *

Leadership Experience

If you have held leadership positions, please list below and describe in detail. Do not duplicate information that is entered elsewhere in the form. Please include the total number of hours in the description of the activity.

Title
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Description
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If you held more than three leadership positions, please provide title, dates position held and a description below.

Research Experience

Did you conduct any research in college, whether in the humanities or science? (Writing a thesis constitutes research.) If so, please describe below any sort of research in which you have engaged. Include the total number of hours completed in each research activity. Please limit your response to one or two paragraphs. If you have publications please list them in this section of the form.

Honors and Awards

Please list below any honors or awards you received in college or post-college, with dates conferred.

Disciplinary Actions

Did you ever receive any disciplinary actions against you while in college? If yes, please describe briefly below the circumstance. Please be honest; I cannot comprehensively advise you without this information. *
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Legal Actions

Have you ever been arrested for any violation of the law? This includes driving while impaired (DWI), driving under the influence (DUI), or any other actions. If yes, please describe the reasons for the arrest in one or two paragraphs. *
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Community Service

What have you done to be of service to others? Please be specific in your descriptions, including name of organizations, time involved, duties, etc. For hours spent, please include the total number of hours for each activity. Do not duplicate information listed elsewhere in the form and do not list medically-related volunteer work in this section. Only include activities that occurred after high school.

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Medical Experiences

Please describe in detail below any clinical experiences you have had (clinics, hospitals, nursing homes, etc.) In your description, please include the reason you chose specific sites, along with the time duration of the involvement and the total number of hours spent in each activity. Please limit your description to one paragraph. If you have more than four clinical experiences please be sure they are included in the resume you attach to this form.

Site Name
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Total number of hours
Description
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Please describe three things you learned from your clinical experiences.

Letters of Evaluation

Letters written on your behalf are an enormously important component of your medical school application. Please indicate whether or not your school has a committee letter and list below the names of individuals who may write letters on your behalf, along with a short description of their relationship to you. If unsure, leave this space blank; this can be discussed in the advising process.
Why do you want to be a doctor? Please use one to two paragraphs below to describe your reasons for wanting to pursue a career in medicine. *
What makes you a distinctive medical school applicant? Please use one to two paragraphs below to articulate what makes you a distinctive medical school applicant. If you’re not sure, leave this space blank.
What, if any, weaknesses do you perceive in your medical school application?
What is your parents’ level of education? Please list below your mother and father, along with the highest level of education achieved.
What are your hobbies? Please list or describe here what you do for fun!
How can I best serve you? Please describe below what you seek in using Thompson Advising services. Be as specific as possible. *
How did you hear about Thompson Advising? *

RELEASE AND DISCLAIMER
This release and disclaimer is additional consideration for the professional services of Thompson Advising, LLC. The undersigned acknowledges and agrees as follows:

The client, and anyone using the services hereunder, hereby releases and discharges Liza Thompson, Thompson Advising, LLC and their agents, servants and employees from any and all liability, claims, damages or actions arising out of or related to this contract or any services, advice or actions of Liza Thompson or Thompson Advising, LLC.

Consideration for this release and disclaimer of liability on behalf of Liza Thompson and Thompson Advising, LLC shall be the services rendered by Liza Thompson and Thompson Advising, LLC. The client acknowledges that the consulting provided by Liza Thompson and Thompson Advising, LLC is not to be construed as obligatory and acknowledges that such consulting provides freedom of personal choice by the client at all times. There is no guarantee, implied or otherwise, that the consulting services provided by Liza Thompson and Thompson Advising, LLC will enhance or in any way guarantee admission to medical school or a post-baccalaureate premedical program.

TERMS AND CONDITIONS
Liza Thompson will provide guidance in the area stipulated by your choice of service option. This service may be limited to a one-hour consultation, additional hourly services, or more comprehensive, packaged services, as selected by the client. Liza Thompson and Thompson Advising, LLC will not write clients’ personal statements or any aspect of the medical school application or other materials. Clients are fully responsible for their medical school or post-baccalaureate premedical program applications, personal statements, and any other application-related materials. It is the client’s responsibility to proofread all material to ensure that it is free of errors and to meet all application deadlines.

Billable services include review of the required information form, transcripts, resumes/CVs; communications, whether oral or written, to discuss the client’s background and strategize; reading and refining personal statements; reading and refining experience descriptions; reading and refining secondary applications; mock interviews; research to provide clients with information; conversations or emails to assist clients with school lists; and any other conversations or emails to assist clients with any other aspects of the medical school or post-baccalaureate premedical program application processes. All communications are tallied in the consulting fee, whether by phone or Zoom conversations, or e-mail. The fee does not include travel to conduct in-person mock interviews for clients. If an in-person interview is requested, additional fees must be paid by the client to cover time and travel expenses.

For the Expert package, if a client decides to take a gap year (or more than one) after signing up for the service and advising extends beyond the initially intended year of submitting a medical school application, additional advising will take place at the hourly rate over the ensuing time period. 

Thompson Advising, LLC or the client may terminate services at any time for any reason. If services are unused the client will be entitled to a refund under the terms listed below.  If a client fails to disclose disciplinary actions or misdemeanors on the Client Information Form, Thompson Advising may terminate the client relationship with no refund given.

All services must be purchased in advance of services rendered.

CHOICE OF LAW AND VENUE
This contract shall be construed in accordance with the Laws of the State of Maryland. All lawsuits or actions seeking any relief or damages arising out of this contract shall be filed in the District Court or Circuit Court of Baltimore County, Maryland.

CANCELLATIONS
Time reserved in the calendar is for the client’s exclusive use. As such, if the client fails to cancel an appointment less than 24 hours in advance, is late, or does not show up for a session the client will be charged for the time.

REFUNDS
If services were purchased at the hourly rate and services go wholly unused the client is entitled to a refund upon written request within 12 months of the purchase, less $25 to cover the nonrefundable PayPal fee and the administrative cost of setting up a client's file. If an hour of time is purchased and not used within 12 months it is forfeited. No partial refunds are given if a client uses a portion of the hour purchased, including time involved to review materials submitted. For fixed price packages, refunds are available if less than one hour of consulting time was used and the written refund request is issued within 12 months of the original purchase date. 

CONFIDENTIALITY AND PRIVACY
All information provided by the client to Liza Thompson and Thompson Advising, LLC is kept in the strictest confidence. No information is ever revealed to third parties at any time. With the client’s written permission, information may be shared with the client’s parents.

ELECTRONIC SIGNATURE
You agree that this Release constitutes "a writing signed by you" under any applicable law or regulation.

Signature *