Student Self-Service Absence Form

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Form Scope

This form is intended for use by students who wish to self-certify an absence from class at Emory College of Arts and Sciences. For courses taught in other Emory schools (e.g. Business, Nursing), please reach out to those faculty directly. This form should only be completed in the following circumstances

Short-Term Illness (which represents 3 days or less of missed class)
Longer-Term Illness (representing four calendar days or more of missed class)
Quarantine
Short-Term Personal Emergency
Religious Holiday Observance
Student Athlete Absence

In cases of bereavement or loss, missed mid terms and finals, or to submit corresponding medical documentation, students should email OUE Academic Advising for information on next steps.

Form Effect

Completion of this form does not grant an immediate excused absence.

Under Emory College of Arts and Sciences academic policy relating to Absence, course instructors maintain the right to determine the effect of absence on a student's academic achievement in a course.

Each instructor affected by your absence will make the final determination on the impact (or lack thereof) towards your overall class performance. Students are encouraged to refer to attendance policies in their course syllabus, and to work with their professors to take appropriate steps to catch-up or submit missed work where appropriate.

Please note: that you are bound by the Emory College Honor Code and misuse of this form and any related processes may be referred to the Emory College Honor Council for investigation and potential sanction.

Student Details

Student ID Number

Legal First Name

Preferred First Name

Last Name

Emory Email Address

By typing your full name below you certify that you understand the scope and effect of this form and that giving false or misleading information for the purpose of gaining an academic advantage is a violation of the Emory College Honor Code, and may lead to disciplinary action.

Absence Details

Reason for Absence

Have you tested positive for Covid-19, displayed symptoms, or had close contact with someone who has?

Yes

No

Have you contacted Student Health Services to report your condition?

Yes

No

Do you live in campus housing or off-campus?

Campus housing

Off-campus

First Date of Absence

Last Date of Absence (if you only missed one day then please set this be the same as first date of absence)

Will your absence include missing graded work such as an exam, midterm or final?

Yes

No

Faculty frequently require documentation to support the rescheduling of graded work. Please reach out to OUE Advising after submitting this form to explain the circumstances and provide documentation which can be shared on your behalf.

Course Overview

Please list each course for which you are registered, with instructor name and email address.

Course 1

Course #1: Number and Title

Instructor #1 Last Name

Instructor #1 Email Address

Course 2

Course #2: Number and Title

Instructor #2 Last Name

Instructor #2 Email Address

Course 3

Course #3: Number and Title

Instructor #3 Last Name

Instructor #3 Email Address

Course 4

Course #4: Number and Title

Instructor #4 Last Name

Instructor #4 Email Address

Course 5

Course #5: Number and Title

Instructor #5 Last Name

Instructor #5 Email Address

Course 6

Course #6: Number and Title

Instructor #6 Last Name

Instructor #6 Email Address

Course 7

Course #7: Number and Title

Instructor #7 Last Name

Instructor #7 Email Address

Course 8

Course #8: Number and Title

Instructor #8 Last Name

Instructor #8 Email Address