Forms

Access the appropriate document link to open, complete form, and print. Follow the instructions on where to submit the completed form.

Absence Notifications

• University Student Absence Form (includes Religious Observation Absence Requests)

Accessibility

• Accommodation Request

Professionalism & Concerns

• CARE Team Referral — Make a referral to help a student or employee in distress.
• Learning Environment Concern Form — The Learning Environment Concern Form is intended for students to privately report any mistreatment, inappropriate behavior or bias of course faculty and clinicians in the academic setting. Submissions are completely anonymous, unless you choose to identify yourself, and are shared with the senior executive director of academic affairs and student services and the college representative to address the concern and consult with the submitting student, if a name is provided, before any action is taken.
• Sexual Misconduct Reporting Form [Title IX Reporting Form] – This form should be used by anyone in the NEOMED community to report sexual harassment, sexual assault or any other forms of sexual misconduct
• Hate and/or Bias Report Form  – NEOMED is committed to a diverse, safe and inclusive learning environment. Members of the NEOMED community who have been targets or witnesses of hate or bias incidents should use this form to report them to the appropriate staff. This form is monitored during business hours only. For emergencies, call 911 and/or NEOMED police at 330-325-5911. You may complete this form after the emergency situation has been resolved.
• Student Conduct/Professionalism Referral Form — This form is for reporting allegations of student misconduct or unprofessional behavior. The submitter’s name is required for investigation purposes but will be kept private. Upon submission, the form will be sent to both the student conduct officer and the college’s professionalism liaison. See more: Student Conduct and Professionalism.
• Suggestion Box — The NEOMED Suggestion Box provides students with the opportunity to provide suggestions, concerns and ideas for how to improve their experience at NEOMED. Suggestions are then reviewed by the elected student leaders in NSC, Student Conduct Council and the college-specific Student Curriculum councils. Suggestions can include ideas about the curriculum, professionalism, facilities, etc. Suggestions may be submitted anonymously. Please avoid using students’ names or using this form for specific professionalism concerns of another student. Instead, use the the Student Conduct/Professionalism Referral Form to report concerns about a specific student.
• Violation of Law Form
• Report an incidence of hazing or learn more about NEOMED’s zero tolerance for acts of hazing
• Student Honor Code 2025-26

Withdrawal Request Form

• Withdrawal Request Form 

Leave of Absence

• Request for Enrichment Leave of Absence (LOA)
• Request for Medical/Personal Leave of Absence (LOA)
• Petition to Return from Leave of Absence (LOA)
• Leave of Absence checklist

International Travel

• International Travel Forms
• International Travel Policy

Consent Forms

• Consent Form: Disclose Educational Records by Dependent Students
• Consent Form: Disclose Educational Records from Parents of Dependent Students
• Consent Form: Release Education Records
• Consent Form: Release or Discuss Medical Records

Credentialing compliance

• • Vaccination Exemption Form

Student Achievement

• Student Achievement Submission Form

Other

Participation Agreement for Not-for-Credit Experiences (College of Medicine) — During medical school, students may choose to engage in off-campus, non-credit experiences (i.e., shadowing, research, etc.) to help enhance their clinical skills or competitiveness for residency placement. These experiences must be:

• at the direction of and approved by College of Medicine, Student Affairs,
• of educational merit, and
• hosted by a physician/principal investigator who has agreed to supervise the student by abiding by the NEOMED Not-for-Credit Guidelines.