Request for Leave of Absence Form (Medical , Military or special circumstance LOA)
LOA’s will not be granted for students who have not 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 and instructor availability.

Students cannot choose or request to be placed in a specific course or class upon return from LOA.

If a student ceases attendance prior to the LOA approval they may be subject to being involuntarily withdrawn. If the student is a Title IV recipient they must meet with Financial Aid prior to being granted a LOA (except for Medical 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.

****SPECIAL CIRCUMSTANCES: DUE TO COVID-19 ASM IS PROVIDING STUDENTS THE OPPORTUNITY TO REQUEST LOA DURING THE PHYSICAL SCHOOL CLOSURE IN ORDER TO BETTER SUPPORT AND SERVE OUR POPULATION, IF YOU ARE A STUDENT WHO WOULD LIKE TO REQUEST A SPECIAL CIRCUMSTANCE LOA YOUR LOA WILL BE GRANTED. PLEASE BE ADVISED YOU'RE DETERMINATION DATE FOR RETURN WILL BE BASED OFF WHERE YOU LEFT OFF IN YOUR PROGRAM. Please contact Charlene Ramos directly at CharleneRamos@AtlantaSchoolofMassage.edu if you have questions of how the LOA will affect your progression through the program specifically.This is the only way you will be excused from the online content. You cannot progress in the program if you are not actively participating in the online course work. ALL STUDENTS REGARDLESS OF MODULE & PROGRAM MAY REQUEST AN LOA FOR THESE SPECIAL CIRCUMSTANCES.***

Email address *
Please provide your full legal name which is on file: *
Your answer
What is the best phone number to contact you? *
Your answer
What is the best email address to contact you? *
Your answer
What is your current program class code? (eg. JA20ED, FB20MD...) *
Your answer
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: *
Your answer
What is your prospective return date? *
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DD
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YYYY
Please explain in detail what actions you have planned in order to help you return within your expected time frame: *
Your answer
Please sign your name: *
Your answer
Please provide today's date: *
MM
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DD
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YYYY
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