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Medical (MD) Student
Leave of Absence (LOA) Request FormPolicy information can be found in the Student Handbook
Medical LOA:
If an LOA is granted by the Office of Student Affairs, I understand I must complete the following during the LOA and before a return from the LOA will be approved:
Request Requirements:
Submit sufficient documentation from a licensed healthcare professional stating that he or she recommends a medical leave of absence from medical school.
You are required to confirm your return date by contacting the College of Medicine Office of Student Affairs no later than 90 days before your anticipated return date from your medical leave of absence so that they Office of Medical Education may appropriately plan and coordinate your academic and clinical schedule for your return.
In order to return form a medical LOA, the student is required to submit a letter from your current treating licensed clinical healthcare provider stating within 30 days prior to the anticipated date of your return stating that you are fit to return to medical school and to continue your training to becoming a physician.
Family LOA Requirements-
If an LOA is granted by the Office of Student Affairs, I understand I must complete the following during the LOA and before a return from the LOA will be approved (initial next to the type of LOA you are requesting):
- Student letter outlining current status of family matter(s)
Financial LOA Requirements-
If an LOA is granted by the Office of Student Affairs, I understand I must complete the following during the LOA and before a return from the LOA will be approved:
- Student letter and supporting documentation from Associate Director of Student Financial Aid regarding resolution of financial matters.
Academic Enrichment Requirements-
If an LOA is granted by the Office of Student Affairs, I understand I must complete the following during the LOA and before a return from the LOA will be approved:
- Student must submit a letter stating their intended academic enrichment plan and submit supportive documentation of such plans (description of research or projects in which she or he participated, degree being pursued, or other forms of academic enrichment along with supportive documentation from the relevant institution(s)).
In order to return from an academic enrichment LOA, students must submit proof of participation in such activities.
Academic Enhancement LOA Requirements-
If an LOA is granted by the Office of Student Affairs, I understand I must complete the following during the LOA and before a return from the LOA will be approved:
Student must meet with the Director of Student Success and Wellness to develop a plan to enhance his or her academic performance over the duration of the LOA and submit supportive documentation demonstrating such plan.
Other LOA Requirements-
If an LOA is granted by the Office of Student Affairs, I understand I must complete the following during the LOA and before a return from the LOA will be approved:
- Documentation outlined by the Office of Student Affairs when LOA is granted
Please read and sign off on the following statements:
- I have met with the Director of Student Financial Aid or Assistant Director of Financial Aid prior to requesting the leave of absence from the College of Medicine.
- I understand that I am required to maintain active health & disability insurance while on a leave of absence.
- I understand that I am required to review and respond, as appropriate, to all email and telephone communications from the Florida Atlantic University Charles E. Schmidt College of Medicine, including during your medical leave of absence.
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