My school here in Virginia has a pre-med advisory commitee. If your school has one and you don't go through through them and get a rec from them, medical schools will wonder why you by-passed them.
At my school they give us all the paperwork for the recomendations we need and they are then sent directly to them. We had to give them a copy of our resume and photo and a personal information sheet with a whole page essay aboyt "Why medicine."
Then in May we had to meet with 2 of the commitee members and have a 30 minute interview. The group is made up of 10 professors both science and nonscience. You are interviewed by someone who has not taught you.
Then they all get together and draft a letter that highly endorses, endorses, or doesn't endorse you and this goes to any of the medical schools along with your other rec forms. This letter states that as a whole your school endorses you.
If you have a pre-med club or a pre-med advisor at your school you need to find out if they write a rec letter.
I am a pre-med officer at my school and we heavily advertised all the info the pre-meds needed to prepare for the commitee.
