Change of Name or Address

Change of Name and/or Address

Please complete this form if your address has changed or your name has changed. If you have any questions, please email or call 501.686.5454.
  • Name currently enrolled as: * Required
  • Name changed to:
  • Is change of name due to marriage? If yes, please send a copy of your marriage license by email (, fax (501.526-3220), or mail to UAMS Registrar's Office, 4301 W. Markham St. Slot 767, Little Rock, AR 72205).
  • Address or New Address * Required
  • I authorize the Graduate School to make the above changes. * Required