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UNIVERSITY MEDICAL REPORT REQUEST FORM

Exceptional Circumstances submissions – PLEASE READ before requesting medical certification

The University committee that considers claims treats all information confidentially. If your claim is accepted, lateness penalties may be removed or the opportunity to take an assessment for the full mark may be offered, but existing marks are never altered.  Further guidance about the University’s late submissions rules, Exceptional Circumstances, SSU and DSA claims as well as possible outcomes is available from the Student Life Centre.

Medical evidence should be submitted in support of an application for:

  • Late submission of assessment(s) or non-submissionof assessment(s)
  • Work submitted on time but reflecting poorerthan expected performance caused by ill health
  • Absence from an unseen examination or otherscheduled in-person assessed test

Please note: You must have consulted your GP Practice during, or immediately after, the illness/incident in question. Claims should only relate to unforeseen short-term illness or accident causing actual incapacity, not minor coughs,colds and everyday stresses. You should not make repeated claims for chronic/ongoing conditions affecting your academic progress. Instead, you should contact the Student Support Unit (SSU). If you are already registered with the SSU and wish to submit a claim relating to an unforeseen/unexpected flare-up of your condition that meets thecriteria above, you may use this form.

These forms can take up to 3 days to complete; however, we aim to complete these as soon as possible.

Once you have received the form back from us, please see the information on the University website HERE regarding the rest of the submission process.

Section 1 - Patient Details

Section 2 - Exceptional Circumstances

Patient's Comments

This reference should have been given to you in a text message – if you have not received a text, just put NA.

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