Absence Notification Form - Second Year Medicine

AY 2019-20

If you are ill and this will prevent you from taking an exam TODAY, you must call or email (or both) your course director immediately. Completing this form is not sufficient.

If this illness will prevent you from attending TODAY's required activity for PCM I or PCM II, you must call or email (or both) the course coordinator immediately. The coordinator needs advance warning of this absence to make arrangements for makeup.

Enter the following information:
What course or activity is affected by this absence?
Reason for absence:
Further reason for absence if explanation is required:
I acknowledge that it is my responsibility to complete the make-up plan that I have worked out with my course director.

When you submit your absence report, a receipt of what you wrote will be automatically sent to your course director, the course coordinator and to you.

Northeast Ohio Medical University