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School of Pharmacy In-course Absence/Impairment Form
Dunedin, New Zealand
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School of Pharmacy In-course Absence/Impairment Form
IN-COURSE ABSENCE/IMPAIRMENT PROCEDURES
PLEASE NOTE THIS FORM IS NOT TO BE USED FOR FINAL EXAMINATIONS (instead use
Application for Special Consideration in Final Examinations Form
).
All in-course tests and assessments (including practicals and workshops) in Pharmacy that count towards your final mark are subject to
University examination regulations
(see University of Otago Calendar).
If you are unable to sit or are impaired during a test, or unable to attend a class that generates course marks please see below:
If you were
ill
and attended the test or assessment or you could not attend at all:
Fill in this form and return it to Reception (7th floor) within 48 hours of the assessment.
A Health Declaration for Special Consideration
must
be completed and
*Section B of this form must be filled out by your GP/Health Care provider.*
This can be uploaded on this web form.
If you consider that other factors beyond your control affected your performance or prevented you from sitting the test or assessment:
Fill in this web form within 48 hours of the assessment.
Attach documents of evidence on this web form (if you are not sure what is required please contact
pharmacy.absence@otago.ac.nz
or see Reception 7th floor).
If you know in advance that you have an
important
commitment (e.g bereavement of immediate family member or a national sporting commitment):
Fill in this web form at least two weeks before the assessment (unless there are exceptional circumstances).
Attach evidence of the event.
The School of Pharmacy will consider each application on a case by case basis.
If you believe you have a disability that will affect your performance:
Fill in this web form at least two weeks before the assessment (unless there are exceptional circumstances).
Contact Disability Information and Support
Attach a statement explaining your request and your disability.
The School will consider the information that you have provided. If more information is required you will be contacted by the School.
Each case will be considered on its merits and one of the following decided:
No action
If an absentee has not submitted a form, or the case is regarded as unacceptable, zero marks will be credited to the end-of-year mark for that test and no special compensation will be made at the final examination.
Students who sit and plead impairment but whose case is not accepted will carry their test marks forward without alteration.
Compensation
If an absence is considered acceptable, or impairment is recognised, the end-of-year contribution of the assessment may be adjusted.
Repeat assessments
Only in exceptional circumstances will there be a repeat assessment.
If the assessment is effectively the final examination, a repeat assessment may be provided but only if the case is fully supported by medical and/or other certificates.
If you are dissatisfied with a decision you may appeal by writing directly to the Dean within one week of the date on the letter of notification.
Fields marked with an
*
must be completed.
Personal information
Family name
*
First/given name
*
Student email
*
Year
*
P2
P3
P4
Group
*
Group A
Group B
Group C
Group D
ID number
*
Your session details
How many classes did you miss? (If more than 5, please complete another submission of this form)
Session 1
Session 1 codes for class 1 that you missed or were impaired in (e.g. PHCY263-W03, PHCY345-L02, PHCY472-W2)
*
Session date
*
Does this session involve assessment?
*
Yes
No
Describe assessment (e.g., assessed lab, group presentation
*
How much is the assessment worth?
*
Session 2
Session 2 codes for class 2 that you missed or were impaired in (e.g. PHCY263-W03, PHCY345-L02, PHCY472-W2)
*
Session date
*
Does this session involve assessment?
*
Yes
No
Describe assessment (e.g., assessed lab, group presentation
*
How much is the assessment worth?
*
Session 3
Session 3 codes for class 3 that you missed or were impaired in (e.g. PHCY263-W03, PHCY345-L02, PHCY472-W2)
*
Session date
*
Does this session involve assessment?
*
Yes
No
Describe assessment (e.g., assessed lab, group presentation
*
How much is the assessment worth?
*
Session 4
Session 4 codes for class 4 that you missed or were impaired in (e.g. PHCY263-W03, PHCY345-L02, PHCY472-W2)
*
Session date
*
Does this session involve assessment?
*
Yes
No
Describe assessment (e.g., assessed lab, group presentation
*
How much is the assessment worth?
*
Session 5
Session 5 codes for class 5 that you missed or were impaired in (e.g. PHCY263-W03, PHCY345-L02, PHCY472-W2)
*
Session date
*
Does this session involve assessment?
*
Yes
No
Describe assessment (e.g., assessed lab, group presentation
*
How much is the assessment worth?
*
Briefly state the reasons why you were absent or consider you were impaired or will be unable to attend
*
Supporting documentation upload
Please upload your supporting documentation. You can upload more than one file.
File types allowed are pdf, jpg, jpeg, jpe, png, bmp, gif, tiff, tif.
Maximum file size to upload is 5MB
Maximum total file(s) size to upload is 25MB
Use the control button when selecting multiple files
on Windows, or command button on Mac
File upload one
Declaration
All the information I have provided is correct and true and I have read the information at the top of this form that outlines the absence/impairment procedures.
Submit
Please wait, file(s) uploading