SELF CERTIFICATION FORM

Discuss any concerns about the effect or your absence on your studies with the Medical School, your Personal Tutor or Student Support as a matter of urgency.

Completing the form:
To notify absence of up to and including five term-time holidays (excluding Saturday and Sunday) due to illness, students should complete the student self-certification form ONLY. Please note that this form should be submitted BEFORE the first missed session starts.

To notify absence of more than five term-time days (excluding Saturdays and Sundays) or absence from any summative examination due to illness, students should complete the student self-certification form and present it and the Medical Certificate form to a doctor, who should complete the later.

Please ensure you have filled in the absence dates correctly before submitting the form as it is not possible to edit these dates after submission.
To notify absence due to a medical appointment, please DO NOT use this form but instead complete the Student Request for Exceptional Absence form.

Note: For notifying absence during the examination period: please inform the FMHS Student Support Team immediately and you will need to complete an application for mitigating circumstances.

Please ensure you have filled in the absence dates correctly, accurately and honestly before submitting this form


- Hold Ctrl and click to select two files.


This information will be held by the Medical School in order to keep a record of student absences.

The Medical School will monitor the frequency of self-certified absences and will follow up on multiple instances of sickness absence via the health concerns process. Confidentiality will be respected and any requests to keep information confidential will be complied with.

By pressing the submit button I agree to the University of Buckingham recording and processing this information about me. I understand that the information will only be used for the purpose(s) set out above and my consent is conditional upon the University complying with its duties and obligations under the Data Protection Act.