Revised August 31
Information about the Verification of Confidential Extenuating Circumstance Form
Students are responsible for providing this documentation to their Faculty/School Office and contacting
their individual instructors to negotiate academic considerations once documentation is processed. The final
decision regarding the academic considerations will be made by the course instructor.
Where can students go for additional information and assistance?
If you require support while speaking with your instructor, you are welcome to contact your
Faculty/School Office for assistance. If you would prefer to speak with someone outside of your
Faculty/School, you can connect with Student Wellness Services. Please contact
firstname.lastname@example.org or 613.533.6000 X 74842.
Disseminate this form – see instructions for individual Faculties/Schools below. Follow the
instructions for the Faculty/School that is granting your degree.
▪ Arts and Science (including students studying at BISC): Submit form to online portal.
▪ Engineering & Applied Science: Submit forms at https://qfeas.it/accom, for assistance email
▪ Nursing (BNSc): Submit form (email or hard copy) to Barb Bolton (Rm 113)
▪ Education (B.Ed): Submit form (email or hard copy) to Alan Wilkinson (Rm A101a)
▪ Commerce: Submit a Request for Academic Consideration for Extenuating Circumstances
online on the Commerce Portal, under Academic Consideration. Submit this form (via
email) to Commerce.AACC@queensu.ca. No hard copy forms accepted.
▪ Law: Submit form (email or hard copy) to Helen Connop (email@example.com)
▪ Medicine: Submit form (email or hard copy) to the Learner Wellness Centre
▪ Occupational Therapy: Submit form (email or hard copy) to your program assistant, Laurie
▪ Physical Therapy: Submit form (email or hard copy) to Program Assistant Lindsey Morey
▪ Bachelor of Health Sciences: Submit form electronically (email only) to the Bachelor of
Health Sciences Program Office (firstname.lastname@example.org)
▪ Graduate Students: Submit form (email or hard copy) to your instructor(s) or supervisor
Meet with student to negotiate academic considerations (i.e., deferral of tests/exams, extensions
on assignments, etc.)
Assess missed academic obligations and provide reasonable academic considerations, in good
faith, while maintaining essential academic requirements and standards
Assure students who are experiencing an extenuating circumstance that reasonable academic
consideration will be implemented, as appropriate, while ensuring essential academic
requirements are met
Who can complete this form?
A student services support professional (e.g., Chaplain, Sexual Violence Prevention and Response
Coordinator, Human Rights Office Advisor, etc.) or a health care provider at Student Wellness
Services or in the community who is aware of your situation can complete this form.