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    This document provides instructions for students seeking documentation to support an application for mitigating circumstances to their college. It notes that the health center can only provide documentation if the student consulted them about their illness or they have supporting hospital records. Documentation is only needed if the student missed over a week of studies, an exam, or a major deadline and their medical issue significantly impacted their performance. Students should not ask for documentation in other situations. The mitigating circumstances report form requires the student's name, date of birth, contact details, department and year in section A. Section B asks for consultation dates, the doctor or nurse seen, the reason for the request, and dates affected. Section C requests the name and email of the student's tutor

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    This document provides instructions for students seeking documentation to support an application for mitigating circumstances to their college. It notes that the health center can only provide documentation if the student consulted them about their illness or they have supporting hospital records. Documentation is only needed if the student missed over a week of studies, an exam, or a major deadline and their medical issue significantly impacted their performance. Students should not ask for documentation in other situations. The mitigating circumstances report form requires the student's name, date of birth, contact details, department and year in section A. Section B asks for consultation dates, the doctor or nurse seen, the reason for the request, and dates affected. Section C requests the name and email of the student's tutor

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    8 views3 pages

    Administration

    Uploaded by

    extreme fattypunch
    This document provides instructions for students seeking documentation to support an application for mitigating circumstances to their college. It notes that the health center can only provide documentation if the student consulted them about their illness or they have supporting hospital records. Documentation is only needed if the student missed over a week of studies, an exam, or a major deadline and their medical issue significantly impacted their performance. Students should not ask for documentation in other situations. The mitigating circumstances report form requires the student's name, date of birth, contact details, department and year in section A. Section B asks for consultation dates, the doctor or nurse seen, the reason for the request, and dates affected. Section C requests the name and email of the student's tutor

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    of 3

    40 Princes Gardens

    Dr S A Freedman
    London
    Dr M S Daniels
    SW7 1LY
    Dr C Allen

    tel: 020 7584 6301

    email: imperialcollege.hc@nhs.net

    www.imperialcollegehealthcentre.co.uk

    Mitigating Circumstances

    Please note that we can only provide support for your mitigating circumstances application, if
    you have consulted us, about your illness or medical problem or we have supporting hospital
    correspondence about it.

    Your college should only require supportive documentation if:

    1. you have missed one week of studies


    2. you have missed or will miss an exam or the deadline for a major piece of course work
    3. and your medical problem has significantly impacted on your general academic
    performance.

    Please do not ask for certification in other circumstances.

    Please ensure all 3 sections of the form is complete. Incomplete forms will not be
    accepted and will cause a delay in your application.

    You should ensure the information you provide to us is consistent with that in your application.
    Please note that all certificates will be e-mailed to your Senior Tutor, Postgraduate Tutor or
    Supervisor as detailed overleaf, who may require to share your certificate with other
    facilities/departments within your college in order to process your application.
    TK April 2023

    Mitigating Circumstances Report


    Information Required
    Section A
    Name: Mr Ian Poon
    Date of birth: 11 Dec 2003
    Current contact details: 07708 798155, 07708 798155, ip323@ic.ac.uk
    (please check details are
    correct)
    CID Number
    Department and
    year:
    Section B
    Approximate date
    of consultation/s:

    Doctor or nurse
    seen:

    Reason for
    request:
    (e.g. missed exam,
    missed deadline)
    Dates affected:

    Outline of how
    you were affected:

    Section C
    Name and email address Name:
    of your Senior Tutor,
    Postgraduate Tutor or Email:
    Supervisor:
    I consent to Imperial College Health Centre providing information about my health to
    Imperial College London / Royal College of Music / Royal College of Art* (*delete as
    appropriate).

    I do / do not* wish to have a copy of the report (*delete as appropriate).

    I do / do not* wish to view the report before it is submitted to my college. (*delete as


    appropriate). Please note viewing the report may cause a delay in submitting to your
    college, which may exceed your submission deadline.

    Full name:

    Signed:

    Date:

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