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Request Instructor Absence Notification


If this is an emergency, call Public Safety at 610-436-3311.

This form is reviewed during normal business hours (M-F, 8am-4pm) and are not monitored after hours, on weekends, or during official university holidays. Referrals using this form should NOT be used in situations requiring emergency response.

The Office of the Assistant Vice President for Health & Wellness provides assistance and support for students who miss a minimum of (3) class days due to illness, personal, or family emergencies.

All supporting documentation submitted is reviewed before formal notification is sent to the student to provide to their faculty. Documentation should include a note or report with the dates of absence.

The formal notification is not intended to serve as an excused absence. The student is encouraged to contact their professors as soon as they can to make arrangements for missed work, as each University professor individually determines their attendance policy. 

COVID-19 Absence Notification - If you are seeking an absence notification due to COVID-19, please fill out the COVID-19 Absence Notification Form and disregard the below form.   

Reporter Information

 
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Student Needing Assistance

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Questions

Where does the student currently live while attending school?(Required)
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What information does the student/family want to share on the letter of notification to faculty about the reason for absence?(Required)
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Has the student notified all of their faculty about this absence?(Required)
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I understand a formal absence notification will be sent to the student to provide to their faculty after Student Assistance reviews and verifies the documentation I submitted. I understand the documentation needs to support (3) or more missed class days relating to my extenuating circumstance.(Required)
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Supporting Documentation

Please attach supporting documentation relating to the absence of (3) or more class days. Chrome browser with PDF or JPG/PNG preferred. HEIC Files cannot be opened by our office. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission