Special Circumstances Form – Explanatory Notes

This form replaces the following University forms: "Student Medical Self-Certificate"; and "Student Sickness Absence Report Form" (these forms should no longer be used).

Notes for Students

1. You should use the University Special Circumstances Form to report the following circumstances:

• Medical circumstances (sickness, injury, surgery/hospitalization etc.) which have resulted in a period of short or longer term absence and/or which have affected performance or examinations/assessment.
• Other personal circumstances which have resulted in a period of absence and/or which have affected performance or examinations/assessment, Examples include: personal/family problems, difficult events (e.g. bereavement), serious incidents (e.g. being affected by crime).

Download a form from the right hand side or collect one from Student Services Information desk (SSiD).

2. You should complete sections 1 and 2 (and 3 and 4 if appropriate) of the form and then pass it to your personal tutor or other appropriate member of departmental staff. They will then, where necessary, complete section 5.

3. If there are non-medical circumstances which may have affected your studies, you may wish to discuss these with your personal tutor. Your department may require you to submit documentary evidence to corroborate these circumstances, especially if these circumstances will be considered by an Examination Board.

Medical Circumstances NOT affecting Examinations/Assessment

4. You are encouraged to manage minor illnesses yourself, e.g. coughs, colds, sore throats etc. You are therefore expected to self-certify for the first 7 days of any illness, by simply completing sections 1 and 2 of the Special Circumstances Form and ticking 2A to indicate "Medical (lasting up to 7 days) – Self-Certification" before forwarding the completed form to your personal tutor or other departmental staff. No medical or doctor's note is required.

5. If your illness or medical problem lasts for more than 7 days, then you should complete sections 1, 2 and 4 of the Special Circumstances Form and tick 2B to indicate "Medical (lasting more than 7 days)". Your department may also require you to produce medical evidence. If you are registered with the University Health Service the doctor you consult can fill in the relevant part of section 4 or in some cases may send a separate note direct to Student Services who will then forward it on to your department. If you are not registered with the University Health Service you should consult your own doctor to obtain a medical note.

However, please note the following with regards obtaining notes from the University Health Service:

1. If you did not consult a doctor at the time you were affected, you should not expect a medical note to be provided retrospectively unless there is other evidence to support your report (e.g. you have an ongoing condition).
2. It is unreasonable to expect your doctor to provide a medical certificate for minor illnesses (e.g. coughs, colds, sore throats etc.) or to substantiate personal matters (such as the death of a relative).

Medical Circumstances affecting Examinations/Assessment

6. If your illness or medical problem affects examinations or assessment, then you should complete sections 1, 2, 3 and 4 of the Special Circumstances Form and tick either 2A or 2B (depending upon the duration of the illness/medical problem) and also tick 2D. Your Department may also require you to produce medical evidence, in which case you should follow the further guidance about how to obtain this under point 5 above. However, please note that points 5a) and 5b) above may still apply.

Notes for Tutors and Other Departmental Staff

7. Space is provided in section 5A of the Special Circumstances Form for tutors or other departmental staff to add any relevant comments if required. Section 5B of the form can be used for tracking purposes (for departmental records, etc). The completed form should then be copied to Dr Helen Grindley in the Taught Programmes Office, who will arrange for it to be circulated to other relevant departments.

8. Please note that University Health Service doctors will be unable to complete section 4 of the form for students who have not consulted the Health Service, or in the case of minor illness (e.g. coughs, colds, sore throats) or personal problems which do not require consultation with a doctor. This includes minor illness affecting examinations/ assessment.

9. If, in exceptional circumstances, a tutor needs to discuss a situation with a doctor at the University Health Service, this can be arranged by telephoning the Practice Manager on extension 22102.