Request for Leave of Absence Form (Medical or Military LOA)
Medical & Military LOA’s may only be granted for students who have successfully completed the Introduction Course of their program. 

Students will be required to retake all course(s) which were not completed with a passing grade and may be required to retake courses as a review if deemed necessary by the program director. Students' placement will depend on space, course rotation and availability. Students cannot choose or request to be placed in a specific course or class upon return from LOA.

The approval and length of a Leave Of Absence will be determined individually and based on specific circumstances. However, in no case will an individual Leave Of Absence be granted for a period longer than 180 calendar days.

If a student ceases attendance and communication prior to the LOA approval they may be subject to being involuntarily withdrawn if they are absent more than 2 weeks, as per policy of the Dept of Education. 

If the student is a Title IV recipient they must meet with Financial Aid prior to being granted a LOA (except for Medical LOA). 

Medical and Military leaves of absence require proper documentation in order for the leave to be granted. Please contact Samantha Yancey directly at SamanthaYancey@AtlantaSchoolofMassage.Edu if you have questions about documentation or of how the LOA will affect your progression through the program specifically.

During their approved LOA timeframe, students will not need to provide coursework or payments to the school until they return from leave; unless otherwise informed to do so. 
Student Records can not answer financial questions. Please discuss any and all financial questions with ASM.Accounting@ AtlantaSchoolofMassage.edu or FinancialAid@AtlantaSchoolofMassage.edu.

Sign in to Google to save your progress. Learn more
Email *
Please provide your full legal name which is on file: *
What is the best phone number to contact you? *
What is the best email address to contact you? *
What is your current program class code?            (eg. JA20ED, FB20MD...) *
Which type of LOA are you taking? *
Please explain in detail why a LOA (leave of absence) is the best course of action for you now: *
What is your prospective return date? (What date do you anticipate being ready to return to the program? Be advised, this is not your scheduled return date - your scheduled return date will be pending administration review) *
MM
/
DD
/
YYYY
Please explain in detail what actions you have planned in order to help you return within your expected time frame: *
Please sign your name: *
Please provide today's date: *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Atlanta School of Massage. Report Abuse