Clinical Observation Form

Clinical Observation (Case Shadow) Form

This form must be completed for each cardiopulmonary bypass (CPB) case observed and signed by the perfusionist you observed to verify your participation in the clinical observation experience.

Reference Form

Applicant Reference Form

This form is to be completed by a reference that will provide insight into your character, work ethic, professionalism, and interpersonal skills. 

2026 - 2027 Application Cycle

The application portal will be open November 1 through December 1, with a link to the online application available on the program’s main webpage during the application period. 

To be considered for this application cycle, applicants must submit their online application by 11:59 p.m. Central Time (CT) on December 1.

There is no advantage to submitting an application early. Applications will not be reviewed until after the application cycle has closed. Applicants are encouraged to use the application period to carefully review their materials and submit a complete and accurate application.

Incomplete applications will not be reviewed or considered for admission. Applicants are responsible for ensuring all required application materials are received. This includes the $100 non-refundable application fee. 

If your application fee is mailed near the deadline, it will be accepted as long as it is postmarked on or before December 1.

Required Application Materials

Applicants should be prepared to provide the following:

  • Demographic information
  • Academic background information
  • Professional background information
  • Prerequisite coursework information, including courses used to fulfill admission prerequisites
  • Personal statement
  • Official transcripts for all completed coursework
  • Three letters of recommendation
  • Three completed Perfusion Education Program Reference Forms
  • Perfusion Clinical Observation (Case Shadow) Form(s)
  • Photo with an unobstructed view of the applicant’s face
  • $100 non-refundable application fee

Clarification for Transcripts, Letters of Recommendation & Reference Forms

Official transcripts, letters of recommendation, and completed Reference Forms may be uploaded with the online application.

If a school or reference prefers to submit materials directly to the program, they may instead email them to perfusion@uiowa.edu. When possible, the applicant’s full name should be included in the subject line so the materials can be matched to the correct application.

Official transcripts are required from every institution where coursework was completed, including coursework that may appear as transfer credit on another institution’s transcript.

Applicants must also provide:

  • Three letters of recommendation
  • Three completed Perfusion Education Program Reference Forms

The three letters of recommendation and three Reference Forms do not need to be completed by the same three individuals.

Important: Upload Requirement for Materials Being Emailed

Due to a limitation in the online application system during this first year, the application requires a document to be uploaded in each of the three designated upload fields for letters of recommendation and Reference Forms.

If your letters of recommendation or Reference Forms will be emailed directly to the program rather than uploaded with your application, you will still need to upload a document in each of the three required fields in order to complete and submit your application.

You may create a simple one-page document indicating that your materials will be submitted separately by email and upload the same document three times—once in each required upload field.

For example:

“My letters of recommendation and/or Reference Forms will be submitted separately by email to perfusion@uiowa.edu by the following individuals:

1. [Name]
2. [Name]
3. [Name]”

Providing the names of the individuals submitting materials on your behalf will help us accurately match Reference Forms and letters of recommendation received by email with your application, particularly if the applicant’s name is not clearly identified in the email or attached document.

Please note: The individuals completing your three Reference Forms do not have to be the same individuals providing your three letters of recommendation. If different individuals will be submitting these materials, please list all applicable names.

This workaround is necessary due to a limitation in the application system for this first year of online applications. We apologize for the inconvenience and appreciate your patience as we transition to the new online application process.

Applicants remain responsible for ensuring that all required transcripts, letters of recommendation, and Reference Forms are received by the program.

Application Fee

A $100 non-refundable application fee must be submitted by check or money order payable to:

University of Iowa Perfusion Education Program

Mail payment to:

University of Iowa Perfusion Education Program
Attn: Deena Furnal-Spruce
200 Hawkins Drive, GH C43-Z
Iowa City, IA 52242

The application fee cannot be paid online, and applications will not be reviewed or considered for admission until payment has been received.

If you mail your payment near the end of the application cycle, it will not be considered late as long as it is postmarked on or before December 1. You may email perfusion@uiowa.edu to notify the program that your payment has been mailed.

Before Submitting Your Application

Please carefully review your application and confirm that:

  • All required fields are complete and accurate.
  • All required documents have been uploaded or arranged for submission by email.
  • Official transcripts from all institutions have been requested.
  • Three letters of recommendation have been arranged for submission.
  • Three Reference Forms have been arranged for submission.
  • All required Clinical Observation (Case Shadow) Forms have been submitted.
  • The $100 application fee has been mailed.
  • If recommendation letters or Reference Forms are being emailed separately, a document has been uploaded in each required application field as described above.

Take the time to submit a complete and accurate application. Submitting early does not provide an advantage in the admissions process.

Questions or Technical Issues

This is the first year the program is accepting applications through an online application process. If you encounter a technical issue or have questions about submitting your application, please email perfusion@uiowa.edu.

Emails will be answered within 24 hours on business days. Emails received on weekends will be addressed on the next business day.

Applicants are encouraged to allow adequate time before the December 1 deadline to resolve questions, obtain missing materials, or address technical issues.

Thank you for your patience as we transition to our new online application process. We appreciate your understanding as we work to make the application experience as clear and efficient as possible.