Class or Clinical Missed Time Sigup
Please fill out the form to submit your request for scheduling missed time. A staff member will contact you within 48 hours to arrange your make-up session. Please submit only one form to ensure the process remains organized and efficient.
Student Name
First Name
Last Name
Program
Please Select
CNA
Phlebotomy Technician
EKG Technician
Home Health Aide
Campus
Please Select
Maple Heights
Akron
E-mail
For student notification
Phone Number
-
Area Code
Phone Number
Total number of CLASS days missed
Please Select
0
1
2
Total number of CLINICAL days missed
Please Select
0
1
2
Comments
Email
example@example.com
Submit
Should be Empty: