STUDENT MEDICAL CERTIFICATE MED - Griffith University
Student Medical Certificate Version 11 0 USING THE GRIFFITH UNIVERSITY MEDICAL CERTIFICATE INFORMATION SHEET This Medical Certificate is provided for use by students of Griffith University in the following circumstances: ♦ where deferred assessment is being sought on medical grounds
Medical Billing & Coding with Medical - Auburn University
The Medical Billing & Coding and Medical Administration Profession Medical billing and coding and medical administration is one of the fastest-growing careers in the healthcare industry today The need for professionals who understand how to code healthcare services and procedures for third-party insurance reimbursement is growing substantially
Bond University Student Medical Certificate
5 Bond University staff may need to verify information provided on this certificate with the relevant Health Care Professional Students applying for deferred examination/s on medical grounds must submit the Bond University Student Medical Certificate, completed by a currently registered and approved Health Care Professional stating:
Student Health Services, Brock University
Medical Certificate To expedite the administration of medical certificates, Brock University requires that this form, Medical Certificate, be used by a student when a medical condition requires special consideration for any academic activity e g missed seminar/lab, assignment extension, deferred examination etc
Student Medical Certificate - Western University
Student Medical Certificate STUDENT NUMBER: I TO BE COMPLETED BY STUDENT: I, (please print) _____, hereby authorize this licensed practitioner to provide the following information to Western University and, if required, to supply additional information relating to my petition for special academic consideration Signature Date
Annexure-I 27 INSTRUCTIONS/GUIDELINES REGARDING COMPETENT
University, Patiala, along with a bank certificate for encashment of foreign currency of the like amount In addition to tuition fee, I shall pay all other dues and charges to the Thapar University, Patiala, as payable by other students of the same class belonging to same category in foreign currency or in
Clinical Medical Assistant Certificate - Auburn University
Clinical Medical Assisting Detailed Course Information: Responsibilities of the clinical medical assistant and introduction to healthcare facilities Medical terminology, anatomy and physiology, circulation of the heart and bl ood vessels Care & safety of patients, medical & legal aspects of care, confidentiality and HIPAA
Professional Practitioner Certificate - University of Sydney
These guidelines have been written to assist you, as a medical/health practitioner, to understand the purpose and use of the University's Professional Practitioner Certificate in the University's special consideration process 1 Use of the Professional Practitioner Certificate
CONFIDENTIAL MEDICAL CERTIFICATE - Human Resources
université d’ottawa university of ottawa confidential medical certificate employee’s statement occ health file no surname given names employee no permanent home address tel no faculty, school, service department, division, section tel no date of birth year month day supervisor
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The personal information on this form is collected under the authority of the University of Western Ontario Act, 1982. The information is collected for the purpose of processing your request for academic
consideration. For further information about this collection, please contact the University Secretary, The University of Western Ontario, Stevenson Hall, Room 4101, London, ON N6A 3K7; Phone 519-661-
2055.Student Medical Certificate
STUDENT NUMBER:
I. TO BE COMPLETED BY STUDENT:
I, (please print) ____________________, hereby authorize this licensed practitioner toprovide the following information to Western University and, if required, to supply additional information relating to my
pe tition for special academic consideration.Signature Date
II. TO BE COMPLETED ONLY BY LICENSED PRACTITIONER: Please indicate the option below that applies, based on
examination and applicable documented history at the time of illness or injury, not after the fact.Initial the most relevant
category Degree of Incapacitation on Academic Functioning Start Date AnticipatedEnd Date
Severe
Completely unable to function at any academic level e.g. unable to attend classes, or fulfill any academic
obligations.Serious
Significantly impaired in ability to fulfill academic obligations e.g. unable to complete an assignment, unable to write a test/examinationModerate
May be able to fulfill some academic obligations but performance considerably affected e.g. able to attend some classes, decreased concentration, assignments may be late. Mild Likely to be able to fulfill academic obligations, but performance affected to a minor degree, with mild impairment and minimal symptoms.Negligible
Unlikely to have an effect on ability to fulfill academic obligations.Describe when/how often you have seen the student with respect to the present illness/episode of illness/injury
Once - Visit Date:
Multiple/On-going - Visit Dates:
Additional Comments:
III. VERIFICATION BY LICENSED PRACTITIONER: I certify that this assessment falls within my legislated scope of practice.
_NAME (please print) REGISTRATION No. CPSO
SIGNATURE DATE
ADDRESS (stamp, business card or letterhead acceptable) TELEPHONE # Completion of this form does not guarantee that special consideration will be granted. Incomplete forms will not be processed.
In some appeal situations, the University my require additional information from you or your practitioner
to decide whether or not to grant or confirm special consideration.