AAMC Video Interview Tool for Admissions: Technical Issue Report Form

This form should be completed within 24 hours after your interview if:

You believe that a technology or system issue interfered with your performance on the video interview; or
Your internet browser closed during the video interview.

Please see the Video Interview Tool for Admissions: Essentials for the AMCAS 2021 Season for more information about reporting a technology or system issue or internet browser closure.

* Indicates required field

First Name:

Last Name:

Email Address:

Phone Number

AAMC ID

When did you take the AAMC Video Interview Tool for Admissions

Using the list below, please select the technology issue(s) you experienced (or think you may have experienced) while completing the AAMC Video Interview Tool for Admissions(Select all that apply):

Microphone and/or video camera would not start recording Microphone and/or video camera stopped recording during the interviewMicrophone recording was very low, had static, and/or was inaudibleVideo camera recording was dim, had visual defects, and/or was not viewableInterview browser closed during interview and/or the computer turned off Unsure if interview saved successfullyOther

When during the interview did you experience this technology issue (e.g., question 2 only, etc.)?

On what kind of device were you taking interview when you experienced the issue?

What browser were you using for your interview when you experienced the issue? (e.g., Google Chrome, Firefox, etc.) ?

Briefly explain the technology issue you encountered. Please be as specific as possible.

Certification and Authorization

Check the following boxes to indicate acceptance of the terms related to your request for a review of your AAMC Video Interview Tool for Admissions due to a technology-related issue.

I understand that the AAMC will review my video responses and interview log and, at its sole discretion, determine whether a technology or system issues affected AAMC’s ability to score my interview.

I acknowledge and agree that the information I submit related to my request for a technology issue review may be used for research purposes pursuant to the AAMC Privacy Statement and the AAMC Policies Regarding the Collection, Use, and Dissemination of Medical Student and Applicant Data.

By typing my name below, I certify that all of the foregoing information in this form is true and complete to the best of my knowledge and that by entering my name I sign this document as if it were my physical signature.

Typed Name

Typed date

AAMC Video Interview Tool for Admissions: Technical Issue Report Form

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