Forms

Access the appropriate document link to open, complete form, and print. Follow the instructions on where to submit the completed form.

Absence Notifications

• University Student Absence Form
• What to do if you test positive for COVID or come in close contact with someone who has.

Consent Forms

• Consent Form: Disclose Educational Records by Dependent Students*
• Consent Form: Disclose Educational Records from Parents of Dependent Students*
• Consent Form: Release Education Records*
• Consent Form: Release or Discuss Medical Records*

Grade Dispute, Hardship & Conflict of Interest

• Student Academic Complaints
• Transfer Credit Appeal Form*

College of Medicine

• Grade Dispute Policy & Notification Form (College of Medicine)
• Grade Dispute Waiver Form* (College of Medicine)
• Hardship Request Form (College of Medicine)
• Conflict of Interest Form (College of Medicine)

College of Pharmacy

• Grade Dispute Policy & Notification Form (College of Pharmacy)

College of Graduate Studies

• Grade Dispute Policy (College of Graduate Studies)

ACCESSIBILITY SERVICES

• Disability Registration and Accommodation Request*

Professionalism & Concerns

• CARE Team Referral
• Learning Environment Concern Form –  The Learning Environment Concern Form is intended for students to privately report any mistreatment, inappropriate behavior or bias of course faculty and clinicians in the academic setting. Submissions are completely anonymous, unless you choose to identify yourself, and are shared with the Senior Exec. Director of Academic Affairs & Student Services and the college representative to address the concern and consult with the submitting student if a name is provided before any action is taken.
• Behavioral Concern (reporting form) – The purpose of the Behavioral Concern form is to report allegations of student misconduct or unprofessional behavior of a student.  Once submitted, the form is received by the Student Conduct Officer and by the College’s professionalism liaison.  Names of the submitter are required but are kept private in the investigation. To learn more, go to the NEOMED Student Conduct webpage.
• Suggestion Box – The NEOMED Suggestion Box provides students with the opportunity to provide their suggestions, concerns and ideas for how to improve their experience at NEOMED. Suggestions are then reviewed by the Elected Student Leaders in NSC, Student Conduct Council and the College-specific Student Curriculum Councils. Suggestions can include ideas about the curriculum, professionalism, facilities, etc.  Suggestions may be submitted anonymously. Please avoid using students’ names or using this form for specific professionalism concerns of another student. The Behavioral Concern form should be used to report concerns about a specific student.
• Violations of the Law Form 
• Student Honor Code 2022-23*

International Travel

• International Travel Forms*
• International Travel Policy*

Leave of Absence

• Enrichment Leave of Absence Form
• Medical/Personal Leave of Absence Form
  • Instructional Video: How to Request an LOA and Petition to Return
• Petition to Return from Leave of Absence Form
• LOA checklist*

CREDENTIALING COMPLIANCE

• Vaccination Exemption Form_

Student Achievement

• Student Achievement Submission Form

Other

• Participation Agreement for Not-for-Credit Experiences (College of Medicine) – During medical school, students may choose to engage in off-campus, non-credit experiences (i.e. shadowing, research, etc.) to help enhance their clinical skills or competitiveness for residency placement. These experiences must: 1) Be at the direction of and approved by College of Medicine, Student Affairs, 2) Be of educational merit, 3) Be hosted by a physician/principal investigator who has agreed to supervise the student by abiding by the NEOMED Not-for-Credit Guidelines.