This form is for Autumn Supplemental Assessment only. 

Please note that any information and documentation supplied with this assessment form will be treated in the STRICTEST OF CONFIDENCE and will NOT be shared with any THIRD PARTY - except when required by Law

Please complete this form and send all relevant supporting documentation by email to Joan.ORiordan@mu.ie for assessment.  

Personal Details
Please note correspondence will be returned to this email address only.
Brief description of reason why you are requesting a Medical/Exceptional Circumstances Waiver. Please note that all medical documentation must have a clear and concise time frame of any illness stated on same.