Absence Notification Form - Third Year Medicine

AY 2019-20

Enter the following information:


Before you submit an absence notification form you must already have made arrangements with your course/clerkship site director on your make-up plan.

Also, the College of Medicine requires that you complete an online form to register your attendance at an academic conference / professional obligation, and receive an acknowledgment from the College, prior to completing this absence form. If you have not done so, please follow this link.

The same holds true for requesting absences for religious holidays: You must complete the religious holiday form and receive an acknowledgment from the College. If you have not done so, please follow this link.

Have you contacted your course/clerkship site director and arrived at a plan for making up time and any required activities missed during absence?


Please note that you will be asked to state on this form the remediation plan that you worked out with your course/clerkship site director. Please do that before you complete this form.

What course or activity is affected by this absence?


If the absence results in you missing a required activity in more than one course, you must submit a separate absence report for each course.

Northeast Ohio Medical University