Absence Request Absence Request Form: You must review the attendance policy before submitting your request. If you fail to review the policy, you risk having your request denied if it is not in compliance with our policy. First and Last Name*UFID*UF Email*Select Your Class Year*Select Your Class YearFirst-YearSecond-YearThird-YearFourth-YearType of Absence Requesting*Select Your Type of AbsencePlanned - Presentation at a Scientific MeetingPlanned - Receiving an AwardPlanned - Representing the CollegePlanned - Job InterviewPlanned - Family/Personal EventPlanned - NAVLE Exam (Offshore Students)Urgent - IllnessUrgent - Family EmergencyUrgent - Death in the FamilyOther Reason - Please explain belowOnly students on clinical rotations are permitted to request absence for a job interview. You are allowed a maximum of three days in a row for interviews. Absences that require more than one day off will need to be made up during your vacation block or during the week preceding graduation.Provide additional details about your situation.*Indicate Interview Details and Employer Information*(Name of Practice / Location / Phone Number)Missed Task*Select your missed taskGraded AssignmentExamLaboratoryClinical RotationMissed Course (Indicate Course Number)*Missed Clinical Rotation*Select Your Clinical RotationAnatomical PathologyAnesthesiologyCardiologyClinical PathologyDermatologyEmergency & Critical CareFood Animal Reproduction and Medicine ServicesLarge Animal Medicine & SurgeryNeurologyOncologyOphthalmologyPrimary Care & DentistryRadiologyShelter MedicineSmall Animal Medicine & SurgeryZoological MedicineThe services described above are in the process of being updated. When you select a service, an email of request will be sent to the Director of Student Affairs for review pending the Service Chief's final approval.Authorizing Faculty/Course Coordinator Name*Authorizing Faculty/Course Coordinator Email*Date(s) of Absences from Clinical Rotation*Format: (MM/DD/YY – MM/DD/YY)Date of Missed Task* Proposed Make-Up Date* Proposed Time of Make-Up* : HH MM AM PM CommentsThis field is for validation purposes and should be left unchanged.