iheed PGT Mitigating Circumstances Online Declaration Form

This form is intended only for students registered on one of the following iheed courses (including PG Certificates and PG Diplomas):

Diabetes Care
Medical Education for Healthcare Professionals
Public Health
Healthcare Leadership
Clinical Research
Neuroscience and Psychology of Mental Health
AI in Healthcare (PG Award only)

The form should be completed and submitted if you wish to notify the University of any mitigating circumstances that you believe have adversely affected your performance, either during the year or in relation to one or more module assessments. Before filling out the relevant sections, please read the University Mitigating Circumstances guidanceLink opens in a new window. You may also find additional useful information and guidance on the further information webpageLink opens in a new window.

The Spring 2026 Board of Examiner meetings for iheed courses will take place in February/March 2026. Students should submit their mitigating circumstances case as soon as they become aware of any circumstances affecting their assessment(s). This form must is submitted within 20 days of the impacted assessment and before results are released. Cases submitted more than 20 days after the impacted assessment are likely to be rejected.

The deadlines to submit claims for consideration at the Spring 2026 Exam Boards are:

Friday, 30 January 2026 for Medical Education and Diabetes Care students
Friday, 06 February 2026 for Public Health and Healthcare Leadership students
Friday, 13 February 2026 for Clinical Research and Neuroscience students

Any submissions received after these deadlines will not be considered by the Mitigating Circumstances panel, so please ensure timely submission.

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Full name

University ID Number

Course of study currently registered for:

Serious accident or illness

Serious accident or illness of someone close

Significant changes in employment circumstances (part-time students only)

Deterioration of a permanent condition

Bereavement

Abrupt change in personal circumstances

Late diagnosis of a specific learning difference

Suffered bullying / harassment / victimisation or threatening behaviour

Other

Other - please provide further information

Please state the length of time/period affected (giving dates), and details of any assessments affected (timeliness):

Period affected (please give start and end date)

Modules and assessment(s) affected (including details of any deadline dates)

Please provide further details of how the mitigating circumstances have affected your learning or assessments (relevance)

Please provide further details of how severely the mitigating circumstances have affected you/ your learning and/or assessment (severity):

iheed Tutor or Programme Manager

University Senior Tutor

Student Support Services

Students’ Union Advice Centre

Doctor

Residential Support

University Counselling Services

Other:

Did not ask for help from the university

If you have answered Other or Did not ask for help above please provide further details

Yes

If yes - please provide details if extensions granted / periods of TWD etc

Yes

Please give details of the evidence of your mitigating circumstances which you are providing or intend to provide with this form

If you have selected other for evidence above please provide further details

Yes

Upload supporting evidence

Attach file

No files are currently attached.

Grant an exceptional third sit of an assessment

Grant a further first attempt at a required assessment

Late penalties waived or partially waived

Recommendation to Senate of an extension to your student registration end date.

Recommendation to Senate that degree classification is changed for a student with a borderline grade/profile.

Other

If you selected other please provide further information fo the recommendation you are seeking

By submitting this form you are confirming that the information you have given is true and that you have read and understood the University Guidance on mitigating circumstances.

Privacy notice

Please note that the information you provide will be reviewed by the departmental mitigating circumstances pre-board in order to make a recommendation to the Board of Examiners about your case. The University will keep your full student record for six years after the end of the academic year in which you graduate from, other otherwise leave the University. After six years, the University will retain only the data necessary to identify you and confirm the dates you studied at the University, the degree and classification you were awarded and a transcript of your marks. All other personal data on your student record will be disposed of in a secure manner.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.