You are required to provide a signed note from a doctor that meets the following requirements: the note must be from a licensed doctor of medicine (MD), osteopathy (DO) or clinical psychologist.

In order to qualify for a Medical Leave, your break in study must be at least: 4 consecutive school days for students enrolled in an morning/evening schedule class and 3 consecutive school days for students enrolled in a weekend schedule class.

Please note that SEVP grants BIA the authority to deny any medical leave request for any reason we do not concur with.

Warning:By signing this form you understand that there is a possibility you may need to repeat your level in a different schedule. If you are currently studying in the evening schedule, you may need to change your schedule to the morning or weekend. If you are studying in the morning or weekend schedule, you may need to change your schedule to the evening.

• All absences, regardless of Medical Leave/Leave of Absence, will count as Absent in the calculation of clock hours.
• Premium ESL 24 students will be required to repeat their level with an ILP on an attendance/academic probation status if they do not attend 80% of the level clock hours (or if they fail to earn a 75% final grade) as the result of Medical Leave/Leave of Absence.
• TOEFL/CBE students will be given an ILP in the next module on an attendance/academic probation status if they do not attend 80% of the level clock hours (or if they fail to earn a 75% final grade) as the result of Medical Leave/Leave of Absence.