Medical Resident Roommate Application Form
Full Name
Age
Email
Phone
Residency Institution / Hospital
Medical Specialty
Residency Year
PGY1
PGY2
PGY3
PGY4+
Desired Move-in Date
Expected Duration of Stay
Gender Preference for Roommate
No preference
Male
Female
Non-binary
Budget (per month)
Lifestyle & Work Hours (e.g. shifts, call schedules)
Living Preferences (e.g. cleanliness, noise, visitors)
Do you have pets?
No
Yes - Dog
Yes - Cat
Yes - Other
Additional Information