Get Yale Medical Leave Form

Completing the Yale Medical Leave Form online is a straightforward process that facilitates your request for a temporary leave of absence due to health reasons. This guide provides step-by-step instructions to ensure you fill out the form accurately and effectively.

Follow the steps to complete the form with ease.

1. Click ‘Get Form’ button to access the medical leave form and open it in an online editor.
2. Begin by entering your personal information in the designated fields. Input your last name, first name, and student ID (SID). Ensure that these details are accurate, as they are essential for identifying your request.
3. Indicate your department and current year of study. Select the term for which you are requesting the leave, either Fall or Spring, by checking the appropriate box.
4. Provide your mailing address including street, city, state, and zip code. Ensure all information is current so that communications can reach you without delay.
5. Fill in your email address and phone number. These contact details are important for follow-up communications regarding your leave request.
6. Request a medical leave by specifying the start and end date of your leave. Make sure to format the dates as month/day/year.
7. List the physician from the Yale Health Service you have requested to provide a written recommendation, along with the name of the Associate Dean to whom the recommendation should be sent.
8. Sign and date the form in the designated areas. This confirms that all the information you have provided is correct and that you wish to proceed with the request.
9. After completing the form, save your changes. You may also choose to download, print, or share the form electronically as needed.

Begin completing the Yale Medical Leave Form online to ensure your request is processed without delay.