This form must be filled out to request or report an absence from

  • a mandatory activity,
  • examination
  • or to request any other exception to College of Medicine policy.

Class absences and personal days can ONLY be approved by your clerkship director.

In emergent situations (i.e. less than 24 hours notice) you need to contact your faculty, coordinator (by phone), AND complete this form as soon as possible.

You must provide all requested information. All information is subject to an independent review and confirmation process.

This policy is described in the section "Attendance and Absenteeism Policies" in the Student Handbook (page. 20) for College of Medicine Students.

NOTE: Absence from a major exam or OSCE due to an illness must be documented by a physician. Personal days may not be taken during an OSCE exam, NBME or other scheduled exam.