• UIWSOM Absence Request

  •  - -
    Pick a Date

  • ***Please note: weddings, vacations, birthdays, and other non-emergency situations will not be considered for excused absence.

  •  / /
    Pick a Date
  •  / /
    Pick a Date
    • COVID-19 Related Section 
    • COVID-19 Related Absence

    • COVID-19 Related Absence - This form is intended for use only for those individuals seeking an excused absence due to a diagnosis, unvaccinated close contact exposure, or suspected diagnosis of COVID-19. 

    •  - -
      Pick a Date
    •  - -
      Pick a Date
    •  - -
      Pick a Date
    •  - -
      Pick a Date
    • function SvgDhtupload2(props) { return /* @__PURE__ */ react.createElement("svg", dhtupload_svg_extends({ width: 54, height: 47, xmlns: "http://www.w3.org/2000/svg" }, props), dhtupload_svg_path || (dhtupload_svg_path = /* @__PURE__ */ react.createElement("path", { d: "M40.213 10.172c1.897.21 3.68.738 5.35 1.58a15.748 15.748 0 0 1 4.374 3.242 15.065 15.065 0 0 1 2.951 4.533c.72 1.704 1.08 3.522 1.08 5.455 0 1.827-.28 3.654-.843 5.48-.562 1.828-1.379 3.47-2.45 4.929A13.39 13.39 0 0 1 46.669 39c-1.599.948-3.452 1.458-5.56 1.528H37.26a1.62 1.62 0 0 1-1.185-.5 1.62 1.62 0 0 1-.501-1.186c0-.457.167-.852.5-1.186.334-.334.73-.5 1.186-.5h3.848c1.44 0 2.75-.37 3.926-1.108a10.851 10.851 0 0 0 3.03-2.846 13.53 13.53 0 0 0 1.95-3.9 14.23 14.23 0 0 0 .686-4.321c0-1.582-.316-3.066-.949-4.454a11.623 11.623 0 0 0-2.582-3.636 12.857 12.857 0 0 0-3.742-2.478 11.054 11.054 0 0 0-4.48-.922l-1.212-.053-.37-1.159c-.878-2.81-2.292-4.998-4.242-6.562-1.95-1.563-4.594-2.345-7.932-2.345-2.108 0-4.005.36-5.692 1.08-1.686.72-3.136 1.722-4.348 3.005-1.212 1.282-2.143 2.81-2.793 4.585-.65 1.774-.975 3.68-.975 5.718h.053l.105 1.581-1.528.264c-1.863.316-3.444 1.317-4.744 3.004-1.3 1.686-1.95 3.584-1.95 5.692 0 2.39.8 4.462 2.398 6.219 1.599 1.757 3.488 2.635 5.666 2.635h4.849c.492 0 .896.167 1.212.5.316.335.474.73.474 1.187 0 .456-.158.852-.474 1.185-.316.334-.72.501-1.212.501h-4.849a10.08 10.08 0 0 1-4.374-.975 11.673 11.673 0 0 1-3.61-2.661 13.173 13.173 0 0 1-2.478-3.9A12.073 12.073 0 0 1 0 28.301c0-2.706.755-5.148 2.266-7.326 1.511-2.178 3.444-3.636 5.798-4.374.14-2.354.658-4.542 1.554-6.562.896-2.02 2.091-3.777 3.584-5.27 1.494-1.494 3.25-2.662 5.27-3.505C20.493.422 22.733 0 25.193 0c1.898 0 3.637.237 5.218.711 1.581.475 3.004 1.151 4.269 2.03a13.518 13.518 0 0 1 3.268 3.215 18.628 18.628 0 0 1 2.266 4.216Zm-11.964 13.44 6.22 6.85c.245.247.368.537.368.87 0 .334-.123.642-.369.923l-.421.263c-.211.246-.484.343-.817.29a1.544 1.544 0 0 1-.87-.448l-3.69-4.11v16.97c0 .492-.166.896-.5 1.212-.334.316-.729.474-1.186.474-.492 0-.896-.158-1.212-.474-.316-.316-.474-.72-.474-1.212V28.25l-3.584 4.005a1.544 1.544 0 0 1-.87.448.959.959 0 0 1-.87-.29l-.42-.264c-.247-.28-.37-.588-.37-.922 0-.334.123-.624.37-.87l6.113-6.746v-.052l.421-.422a.804.804 0 0 1 .396-.29c.158-.053.307-.079.448-.079.175 0 .333.026.474.079.14.053.281.15.422.29l.421.422v.052Z", fill: "none" }))); }
      Browse Files
      Drag and drop files here
      Choose a file
      Cancelof
    • COVID-19 Related Section End 
    • Personal Day Request Section 
    • Personal Day Request

    • Personal Days - Learners are permitted to take two personal days per academic year which do not count as absences. Personal days are not to be taken during an assessment period, scheduled or mandatory workshops, such as DOCS and/or STRX. Personal Day Absence Requests must be submitted a minimum of five days prior. Failure to do so may result in a professionalism violation. 

      The Student Handbook, which contains additional information regarding absences, can be found on the Current Students Page.

    • Personal Day Request Section End 
    • Short Term Absence Section 
    • Short-Term Absence Request

    • Short Term Absence - When an absence is necessary and anticipated, learners must submit a Short-Term Absence From. This form must be completed at least ten business days prior to the event. 

      When an absence is the result of an unexpected occurrence, learners must complete a Short-Term Absence Form as soon as possible, but no later than the first date of return to campus. 

      Absence from class for medical issues (self or immediate family), military obligation, civic duties, professional activities, funerals (immediate family), traffic accidents, and other exceptional situations are considered on a case-by-case basis.

      Examples of unexcused absences include weddings, vacations, birthday, and other family non-emergency events. This list is not inclusive of all circumstances. The request is not considered approved until receipt of an affirmative response from the OASA or OCA. 

      Learners with more than five single day excused absences (per academic year) or any unexcused absences will be referred to OASA and may also be referred to the SPC. All unexcused absences will be reviewed on a case-by-case basis to determine the most appropiate course of action. 

      The Student Handbook, which contains additional information regarding absences, can be found on the Current Students Page.

    • function SvgDhtupload2(props) { return /* @__PURE__ */ react.createElement("svg", dhtupload_svg_extends({ width: 54, height: 47, xmlns: "http://www.w3.org/2000/svg" }, props), dhtupload_svg_path || (dhtupload_svg_path = /* @__PURE__ */ react.createElement("path", { d: "M40.213 10.172c1.897.21 3.68.738 5.35 1.58a15.748 15.748 0 0 1 4.374 3.242 15.065 15.065 0 0 1 2.951 4.533c.72 1.704 1.08 3.522 1.08 5.455 0 1.827-.28 3.654-.843 5.48-.562 1.828-1.379 3.47-2.45 4.929A13.39 13.39 0 0 1 46.669 39c-1.599.948-3.452 1.458-5.56 1.528H37.26a1.62 1.62 0 0 1-1.185-.5 1.62 1.62 0 0 1-.501-1.186c0-.457.167-.852.5-1.186.334-.334.73-.5 1.186-.5h3.848c1.44 0 2.75-.37 3.926-1.108a10.851 10.851 0 0 0 3.03-2.846 13.53 13.53 0 0 0 1.95-3.9 14.23 14.23 0 0 0 .686-4.321c0-1.582-.316-3.066-.949-4.454a11.623 11.623 0 0 0-2.582-3.636 12.857 12.857 0 0 0-3.742-2.478 11.054 11.054 0 0 0-4.48-.922l-1.212-.053-.37-1.159c-.878-2.81-2.292-4.998-4.242-6.562-1.95-1.563-4.594-2.345-7.932-2.345-2.108 0-4.005.36-5.692 1.08-1.686.72-3.136 1.722-4.348 3.005-1.212 1.282-2.143 2.81-2.793 4.585-.65 1.774-.975 3.68-.975 5.718h.053l.105 1.581-1.528.264c-1.863.316-3.444 1.317-4.744 3.004-1.3 1.686-1.95 3.584-1.95 5.692 0 2.39.8 4.462 2.398 6.219 1.599 1.757 3.488 2.635 5.666 2.635h4.849c.492 0 .896.167 1.212.5.316.335.474.73.474 1.187 0 .456-.158.852-.474 1.185-.316.334-.72.501-1.212.501h-4.849a10.08 10.08 0 0 1-4.374-.975 11.673 11.673 0 0 1-3.61-2.661 13.173 13.173 0 0 1-2.478-3.9A12.073 12.073 0 0 1 0 28.301c0-2.706.755-5.148 2.266-7.326 1.511-2.178 3.444-3.636 5.798-4.374.14-2.354.658-4.542 1.554-6.562.896-2.02 2.091-3.777 3.584-5.27 1.494-1.494 3.25-2.662 5.27-3.505C20.493.422 22.733 0 25.193 0c1.898 0 3.637.237 5.218.711 1.581.475 3.004 1.151 4.269 2.03a13.518 13.518 0 0 1 3.268 3.215 18.628 18.628 0 0 1 2.266 4.216Zm-11.964 13.44 6.22 6.85c.245.247.368.537.368.87 0 .334-.123.642-.369.923l-.421.263c-.211.246-.484.343-.817.29a1.544 1.544 0 0 1-.87-.448l-3.69-4.11v16.97c0 .492-.166.896-.5 1.212-.334.316-.729.474-1.186.474-.492 0-.896-.158-1.212-.474-.316-.316-.474-.72-.474-1.212V28.25l-3.584 4.005a1.544 1.544 0 0 1-.87.448.959.959 0 0 1-.87-.29l-.42-.264c-.247-.28-.37-.588-.37-.922 0-.334.123-.624.37-.87l6.113-6.746v-.052l.421-.422a.804.804 0 0 1 .396-.29c.158-.053.307-.079.448-.079.175 0 .333.026.474.079.14.053.281.15.422.29l.421.422v.052Z", fill: "none" }))); }
      Browse Files
      Drag and drop files here
      Choose a file
      Cancelof
    • Short Term Absence Section End 
    • Extended Leave of Absence Section 
    • Extended Leave of Absence Request

    • ***The Extended Leave of Absence process below applies to DO program only. MBS learners must use: UIW Leave of Absence Request

      Extended Leave of Absence - An absence of more than seven consecutive days is considered an extended leave of absence. An extended leave of absence may be requested for academic or medical reasons, finances, family leave, active military deployment, and other exceptional situations considered on a case-by-case basis. A leave of absence request must be approved by the Office of Admissions and Student Affairs, in consultation with appropriate faculty, staff, and administrators.

      Please review the Student Handbook for detailed information on eligibility requirements, approval process, term limits, etc.

       

    • Prior to submitting this Extended Leave of Absence Request, it is recommended to meet with the following representatives to discuss the impact of your LOA.

      Phase I Learner:

      • Office of Admissions and Student Affairs - Ms. Ladonna Davidson*
      • Phase I Co-Director of Curriculum Integration - Dr. Jessica Bradley*
      • Academic Support - Dr. Sarah Lang
      • Enrollment Services - Ms. Celia Velez
        *Discussion can be combined

      Phase II Learner:

      • Office of Admissions and Student Affairs -  Ms. Ladonna Davidson*
      • Phase II Co-Director of Curriculum Integration - Dr. Lori Kels*
      • Office of Clinical Affairs - Dr. David Garza*
      • Academic Support - Dr. Sarah Lang
      • Enrollment Services - Ms. Celia Velez
        *Discussion can be combined

      MPH Learner:

      • Office of Admissions and Student Affairs - Ms. Ladonna Davidson
      • MPH Director - Dr. Karen Jaceldo-Siegl
      • Enrollment Services - Ms. Celia Velez
    •  - -
      Pick a Date
    • Dual degree learners taking a LOA from DO and MPH must submit two (2) seperate absence requests - one for DO and one for MPH.

    • Administrative Leave of Absence - An administrative leave of absence is one that is granted or required by the Associate Dean of Medical and Interprofessional Education or the Associate Dean of Clinical Affairs for a student who requests of requires a leave of absence lasting between 8 days and 180 days. Reasons for an Administrative Leave of Absence include:

      •    Death of a spouse, partner, child or immediate family member.
      •    Critical illness of a spouse, partner, child or immediate family member.
      •    Significant life events that warrant an interruption in the student's education.
      •    Activities or programs that OMIE, OCA or SPC require.

    • Educational Leave of Absence - When accepted to a dual degree academic program (such as DO/MBA, DO/MPH) or in a structured research program that has prior approval by UIWSOM administration, the student may be placed on an approved Educational Leave of Absence from the DO program to complete the dual degree program. An Educational Leave of Absence is generally limited to one year.

    • Medical Leave of Absence - Clarification or substantiation for the medical leave of absence may be required if the medical leave is not common for the medical condition, to confirm that a medical condition exists, or if a second opinion from a physician is warranted.

    • function SvgDhtupload2(props) { return /* @__PURE__ */ react.createElement("svg", dhtupload_svg_extends({ width: 54, height: 47, xmlns: "http://www.w3.org/2000/svg" }, props), dhtupload_svg_path || (dhtupload_svg_path = /* @__PURE__ */ react.createElement("path", { d: "M40.213 10.172c1.897.21 3.68.738 5.35 1.58a15.748 15.748 0 0 1 4.374 3.242 15.065 15.065 0 0 1 2.951 4.533c.72 1.704 1.08 3.522 1.08 5.455 0 1.827-.28 3.654-.843 5.48-.562 1.828-1.379 3.47-2.45 4.929A13.39 13.39 0 0 1 46.669 39c-1.599.948-3.452 1.458-5.56 1.528H37.26a1.62 1.62 0 0 1-1.185-.5 1.62 1.62 0 0 1-.501-1.186c0-.457.167-.852.5-1.186.334-.334.73-.5 1.186-.5h3.848c1.44 0 2.75-.37 3.926-1.108a10.851 10.851 0 0 0 3.03-2.846 13.53 13.53 0 0 0 1.95-3.9 14.23 14.23 0 0 0 .686-4.321c0-1.582-.316-3.066-.949-4.454a11.623 11.623 0 0 0-2.582-3.636 12.857 12.857 0 0 0-3.742-2.478 11.054 11.054 0 0 0-4.48-.922l-1.212-.053-.37-1.159c-.878-2.81-2.292-4.998-4.242-6.562-1.95-1.563-4.594-2.345-7.932-2.345-2.108 0-4.005.36-5.692 1.08-1.686.72-3.136 1.722-4.348 3.005-1.212 1.282-2.143 2.81-2.793 4.585-.65 1.774-.975 3.68-.975 5.718h.053l.105 1.581-1.528.264c-1.863.316-3.444 1.317-4.744 3.004-1.3 1.686-1.95 3.584-1.95 5.692 0 2.39.8 4.462 2.398 6.219 1.599 1.757 3.488 2.635 5.666 2.635h4.849c.492 0 .896.167 1.212.5.316.335.474.73.474 1.187 0 .456-.158.852-.474 1.185-.316.334-.72.501-1.212.501h-4.849a10.08 10.08 0 0 1-4.374-.975 11.673 11.673 0 0 1-3.61-2.661 13.173 13.173 0 0 1-2.478-3.9A12.073 12.073 0 0 1 0 28.301c0-2.706.755-5.148 2.266-7.326 1.511-2.178 3.444-3.636 5.798-4.374.14-2.354.658-4.542 1.554-6.562.896-2.02 2.091-3.777 3.584-5.27 1.494-1.494 3.25-2.662 5.27-3.505C20.493.422 22.733 0 25.193 0c1.898 0 3.637.237 5.218.711 1.581.475 3.004 1.151 4.269 2.03a13.518 13.518 0 0 1 3.268 3.215 18.628 18.628 0 0 1 2.266 4.216Zm-11.964 13.44 6.22 6.85c.245.247.368.537.368.87 0 .334-.123.642-.369.923l-.421.263c-.211.246-.484.343-.817.29a1.544 1.544 0 0 1-.87-.448l-3.69-4.11v16.97c0 .492-.166.896-.5 1.212-.334.316-.729.474-1.186.474-.492 0-.896-.158-1.212-.474-.316-.316-.474-.72-.474-1.212V28.25l-3.584 4.005a1.544 1.544 0 0 1-.87.448.959.959 0 0 1-.87-.29l-.42-.264c-.247-.28-.37-.588-.37-.922 0-.334.123-.624.37-.87l6.113-6.746v-.052l.421-.422a.804.804 0 0 1 .396-.29c.158-.053.307-.079.448-.079.175 0 .333.026.474.079.14.053.281.15.422.29l.421.422v.052Z", fill: "none" }))); }
      Browse Files
      Drag and drop files here
      Choose a file
      Cancelof
    •  - -
      Pick a Date
    • Extended Leave of Absence Section End 
    • DO Classes/Assessments 
    • ***Supporting documentation is required for all absences during assessments.***

      You may submit your request without the supporting documentation, but you must provide the supporting documentation to Ms. Ladonna Davidson within 3 business days to avoid delays in makeup exam scheduling.

    • DO Classes/Assessments 
    • MBS Classes/Assessments 
    • MBS Classes/Assessments 
  • *A student who is absent for more than three days without approval shall meet with the Office of Admissions and Student Affairs and may be referred to the SPC to address the student's absenteeism.

    I acknowledge that I have reviewed the attendance policies outlined in the University of the Incarnate Word School of Osteopathic Medicine's Student Handbook.

    By clicking "Submit" I am signing this form electronically. I agree my electronic signature is the equivolent of my manual signature on this form. 

  • Should be Empty: