Forms

New Student Wellness Patients

To help speed up your registration process, please fill out the following form and email it to health.services@queensu.ca prior to your first medical or mental health appointment. Please note that if your paperwork is not completed and submitted prior to your appointment, it may not be possible to proceed and we may need to reschedule. 

If you are a student with a disability and would like to register with Accessibility Services, please click here


Extenuating Circumstances

Steps to take if a student experiences a circumstance outside their control (e.g., health condition, family member death, challenge with housemates, etc.) and it is impacting their academics:

  1. Do you need medical or mental health care (i.e., need to connect with physician, counsellor, nurse, occupational therapist)? If yes, book an appointment at Student Wellness Services.
     
  2. Are you registered with Accessibility Services (QSAS) for the circumstance that is currently impacting your academics?
     
    1. If yes, email your course instructor(s) and copy your QSAS Advisor with your request for accommodation.  If you are requesting a deferral for a centrally scheduled final exam, email the Exams Office (exams@queensu.ca) to cancel your exam accommodations. If you are uncertain about who your advisor is please email accessibility.services@queensu.ca.
       
    2. If no, how long do you think your circumstance will impact your academics?
      1. If 3 days or less – complete the Request for Academic Consideration Form. No medical documentation is required. Follow instructions for your Faculty/School (in Section F). Students in Arts & Science, Commerce, and Engineering may need to complete the Formal Attestation Form as their supporting documentation (see Section F).
         
      2. If 3 days or more – you will need supporting documentation for your consideration request. Documentation needed may vary depending on the nature of your circumstance (see “what supporting documentation do I need?” below). If you are seeing a healthcare provider, be sure to ask for documentation.

If you have an ongoing disability or diagnosed health condition, we encourage you to consider registering with Queen’s Student Accessibility Services (QSAS) for ongoing accommodations, when you are able. Find out how to register with QSAS and disability documentation requirements.

Info for Students

Your studies may be impacted by illness or unexpected events during your time at Queen’s. The Academic Consideration for Students in Extenuating Circumstances Policy outlines the approach to providing students with extenuating circumstances with consistent and fair academic consideration.

Find additional supports & resources if you have a circumstance impacting your academics.

 

Do You Have an Extenuating Circumstance?

An extenuating circumstance is a personal circumstance beyond your control, (e.g., sudden or acute physical illness or mental distress, serious injury to yourself or significant others, bereavement, traumatic event, etc.) that has a direct and substantial impact on your ability to temporarily meet essential academic requirements or standards. 

The Policy on Academic Considerations for Students in Extenuating Circumstances enables students with extenuating circumstances to request academic consideration in a fair, reasonable and consistent manner.

Academic Consideration vs Academic Accommodations

Academic Considerations

Academic consideration is an action taken by an educator in response to a student with an extenuating circumstance. Academic considerations are intended to minimize the impact of a serious or significant extenuating circumstance that is beyond a student’s control. Considerations may include but are not limited to: an excused absence, a brief reprieve from coursework, extended or deferred deadline, a modified schedule for assignments, labs, placements, projects, or comprehensive exams, a deferred exam or project, a medical leave of absence, an alternate assignment, a re-weighting of assigned marks, course withdrawal without penalty, or other considerations deemed appropriate by a Faculty or School Office.

Academic Accommodations

Academic accommodations are put in place to equalize learning opportunities and access to the academic environment for students with disabilities. A disability may include a temporary (e.g., a concussion or a broken arm) or permanent (e.g., a learning disability) condition. The functional limitations resulting from a disability can at times intersect with the academic environment in a way that creates a barrier for students. Some examples of accommodations include extra time on exams, permission to use assistive technology for exams, or permission to audio record lectures.

Supporting documentation can include the following:

Students who experience unforeseen technological or workspace disruptions that are beyond their control (e.g. hardware malfunction, unexpected internet connectivity issue, power outage, fire alarm, unexpected need to care for children, etc.) may be able apply for academic consideration. For more information about how to apply for this academic consideration, click on your individual Faculty/School website found in the section below.

Students who experience chronic technological difficulties or workspace disruptions (e.g. long-term hardware/software failure, prolonged poor internet coverage, lack of planning or knowledge of program software/onQ, missing notifications/reminders, use of unsupported/out-of-date software, etc.) would not qualify for academic consideration. Students requiring financial assistance to plan and mitigate against chronic disruptions are encouraged to apply for bursary funding from Student Awards.
 


 

Info For Faculty and Staff

A student’s studies may be impacted by illness or unexpected events during their time at Queen’s University. The university has developed a policy to outline the approach to providing students with extenuating circumstances with consistent and fair academic consideration.

Academic Considerations

Academic consideration is an action taken by an educator in response to a student with an extenuating circumstance. Academic considerations are intended to minimize the impact of a serious or significant extenuating circumstance that is beyond a student’s control.

Considerations may include but are not limited to: an excused absence, a brief reprieve from coursework, extended or deferred deadline, a modified schedule for assignments, labs, placements, projects, or comprehensive exams, a deferred exam or project, a medical leave of absence, an alternate assignment, a re-weighting of assigned marks, course withdrawal without penalty, or other considerations deemed appropriate by a Faculty or School Office.

Academic considerations are determined based on a conversation between the student and their instructor. Students are advised to submit documentation and/or forms related to the Policy on Academic Considerations for Students in Extenuating Circumstances through the Faculty or School Office that is granting their degree.  Students are responsible for contacting their individual instructors to discuss academic considerations once documentation is processed. The final decision regarding the academic considerations are made by the course instructor.

Academic Accommodations

Academic accommodations remove disability related barriers and enable students to access the academic environment.  Students will either receive permanent or interim accommodations which are approved by Queen’s Student Accessibility Services (QSAS) based on medical documentation that meets QSAS documentation criteria.  Find some of the accommodations that may be approved as part of the accommodation process.

Letter of Accommodation (LoA)

  • Accommodations can interim or permanent (accommodation expiry dates will be specified on the form)
  • If this student requests an assignment extension or exam deferral for reasons of a disability for which they are accommodated through their LoA, please do not refer them to the Extenuating Circumstances Policy.  Students are advised to email their instructor and copy their QSAS Advisor if they need an extension or deferral.  If you have questions or concerns considering any requests, please contact the students QSAS Advisor.

Paperwork for Students Requesting Academic Consideration

Students must submit the Request for Academic Consideration for Extenuating Circumstances Form (with supporting documentation, if required) to their Faculty/School Office.  Visit Section F of this form to understand this process for your Faculty/School.  Most of the time forms are sent directly to Faculty and Staff.

Students who submit multiple “Request for Academic Consideration for Extenuating Circumstance” forms without documentation

A student may have multiple extenuating circumstances throughout a term or academic year and need to use a Request for Academic Consideration for Extenuating Circumstances Form (without documentation).. It is recommended that the instructor contact the student’s Faculty or School Office to determine the appropriate next steps, and ensure the student has the appropriate supports in place.

Some Faculties/Schools require students to provide documentation when submitting more than one request in a term, particularly during midterms or final exams. If documentation is not available (e.g., the student was at home and not seen by a health care provider), a Formal Attestation of Extenuating Circumstances Form, signed at the Faculty Office, may be submitted.

Students should submit a Request for Academic Consideration for Extenuating Circumstance Form until they are able to submit the Formal Attestation.  Please see Section F (page 3) of the Request for Academic Consideration for Extenuating Circumstance Form and/or consult your Faculty or School website for more information.

Students who request an academic consideration and are registered with Accessibility Services (QSAS) 

Students who experience functional impairments due to an ongoing health condition are encouraged to registered with Accessibility Services (QSAS).  Despite having these accommodations, students may require additional support (beyond what it outlined in their Letter of Accommodations (LoA). For example, a student with irritable bowel syndrome experiences worsening symptoms and need extension on assignment, absence from class, deferral of an exam/test/quiz).

In these situations, students are instructed to email their instructors and copy their QSAS Advisor.  The student is NOT required to submit any documentation or forms from the Extenuating Circumstances Policy to support this request. The Accessibility Services Advisor will ensure the documentation on file at QSAS supports this request, and will follow-up with the instructor or student if they have any concerns.

Students who submit a Request for Academic Consideration for Extenuating Circumstances Form without documentation (i.e., 3 days or less) and request an additional day.

Students need to submit a new Request for Academic Consideration for Extenuating Circumstances Form to their Faculty/School Office, and provide supporting documentation to extend their request beyond 3 days.

Concern over legitimacy of an academic consideration request

The Academic Considerations for Students in Extenuating Circumstances Policy is based on the principle of “good faith.” Instructors, Faculty and School Offices are advised to presume that all involved are acting with honest and sincere intentions. If you are concerned about the legitimacy of a request, you are welcome to consult with your Faculty or School Office. Students will submit a request for academic consideration to the Faculty/School Office that is granting their degree. The Faculty/School Office will review and verify the documentation provided (if required) and instructors will be advised of the expected duration of the student’s extenuating circumstance as well as the severity of the impact of this circumstance on the student’s ability to participate in academics.

Determining which academic considerations are appropriate based on the documentation

The documentation, provided from the Faculty/School Office, will likely outline whether a student is capable of completing any course work, and give some idea as to the amount of course work a student can complete (i.e., can the student attend classes and complete assignments?). The instructor should begin by considering the student’s progress in the course, the course requirements, and the severity of the impact of the extenuating circumstance.

In the event the individual completing the documentation suggests a student will be unable to complete any course work for several weeks, an instructor may advise the student to follow-up with the Faculty or School Office to investigate options for course withdrawal without penalty. If the student is unable to complete any work for up to a week, the instructor may consider providing the student with an extension or deferral on any evaluations and allow the student to be absent from tutorials or labs, where possible. If a student has completed all of the course work thus far, but has a final exam to complete, the instructor may allow the student to delay the exam until the student is able to write, based on the anticipated resolution of the extenuating circumstance.

In the event there is uncertainty about the appropriate academic consideration, please connect with the contact within your Faculty or School Office for guidance.

Note: Instructors should NOT provide informal academic accommodations to a student based on documentation received through the Extenuating Circumstances Policy. If a student requests academic accommodations (e.g., extra time on an exam, separate room to write an exam, computer to write an exam), direct the student to connect with Accessibility Services (QSAS)

Including academic consideration information in a course syllabi

Please first refer to your Faculty/School Office for a statement regarding the Policy on Academic Consideration for Students with Extenuating Circumstances. If a statement is not available, you are welcome to use the following statement:

Queen’s University is committed to providing academic consideration to students experiencing extenuating circumstances that are beyond their control and which have a direct and substantial impact on their ability to meet essential academic requirements (e.g., death of a family member, short-term illness). If you have an extenuating circumstance during this course, please go here for additional information regarding how to submit a request for academic consideration.

Physical or mental health supports for students with an extenuating circumstances

Find other supports and resources available on- and off-campus.

Contacts for Individual Faculty and School Offices

Faculty of Arts and Science

asc.consideration@queensu.ca
Faculty of Arts and Science (online portal for requests for academic consideration)

Faculty of Engineering and Applied Science

engineering.aac@queensu.ca
(613) 533-6000 x 78013
Faculty of Engineering and Applied Science

Smith School of Business (Queen’s Commerce)

commerce.aacc@queensu.ca
613.533.2324
Smith School of Business (go to the Commerce Portal for your program for additional information)

Faculty of Law

law.accommodations@queensu
613.533.6000 X78147
Faculty of Law

School of Medicine

Dr. Richard Van Wylick
3wrcv@queensu.ca
School of Medicine

Faculty of Education

Stephanie Barnaby
stephanie.barnaby@queensu.ca
613.533.6000 X75476
Faculty of Education (if you are in concurrent-ed, contact your undergraduate faculty otherwise, contact the Associate Dean)

School of Rehabilitation Sciences

Occupational Therapy

ot.info@queensu.ca

Physical Therapy

programassistant.pt@queensu.ca

Bachelor of Health Sciences

bhsc@queensu.ca
613.533.2566
Faculty of Health Sciences

School of Nursing

Barbara Bolton
boltonb@queensu.ca
613.533.6000 X74751
School of Nursing

School of Graduate Studies

School of Graduate Studies


QSAS Documentation

Students who require academic accommodations can find additional information about accessibility documentation requirements and forms.


Transfer of Records   

To have your records sent to another physician/location or to obtain copies of your medical records please complete the Consent Regarding Personal Health Information form indicating specifically what you require (e.g., immunization record, entire chart, recent bloodwork) and drop it off at Student Health or send it by email to: sws.records@queensu.ca

Students can also obtain records in person without filling out a release of information by showing identification that has a picture at the SWS reception desk in Mitchell Hall.

There is a $40 fee for transferring records.

If you have questions related to the transfer of your records, please contact:
Phone: 613-533-6000 x 74509
Email: sws.records@queensu.ca