Any further comments made by student e.g. aches/pains health problems being experienced. List agreed adjustments and control measures. Review date ………………………………… This checklist has been completed to the best of my knowledge Student Date signature ………………………………………………… ………………… Registrars signature Date …………………………………………………… …………………… The Faculty Registrar should retain this form and send a copy to:
Any further comments made by student e.g. aches/pains health problems being experienced. List agreed adjustments and control measures. Review date ………………………………… This checklist has been completed to the best of my knowledge Student signature ………………………………………………… Date ………………… Registrars signature …………………………………………………… Date …………………… The Faculty Registrar should retain this form and send a copy to: