Medical Self-Declaration Form / Student Absence Self-Declaration Form

This page contains information on the provision of Brock’s Student Medical Self-Declaration Form within Brightspace. While not required, students can be granted easy access to said form at the behest of an instructor. This guide will help create an in-Brightspace Assignment that facilitates and tracks this activity.

The Self-Declaration Form replaces the need for a medical note and supporting documentation from a health care provider when, in the case of a short-term medical, mental health, or other distressing personal circumstance, a student wishes to seek an academic consideration.

Learn more about the Form and other services from Student Health Services (p: 905-688-5550 x3243).

The Student Medical Self-Declaration Form is available online and can be downloaded or shared as a link. Students can submit a completed form by email if it is not provided through a Brightspace Assignment.



Create an Assignment that tracks Self-Declaration Form submissions

Instructors can choose to download a prefabricated assignment package and import that into a course site, or to create an Assignment themselves with the few necessary options. This Assignment will have the Form attached and can be used to track submissions over the duration of the course, and can be set to allow only a single submission per Note 1 in the Form.

Download the Assignment package

CPI has created a .zip file containing a pre-made Brightspace Assignment for the Form with the necessary options and restrictions in place.

  1. Download the file directly:

  2. Import to a course site using the Import/Export/Copy Components tool.

Create an Assignment

Instructors familiar with doing so may wish to create an Assignment themselves. Full details on all possible options are available in the article on Assignment creation.

  1. Create an Assignment.

  2. Add instructions for students with regard to completing and submitting the Form. Policy and official procedure is explained in the Form itself, but students must download, fill out, save, and then upload the Form as a submission to the Assignment.

  3. Include the Form as a file attachment for students ().

  4. In the Submission & Completion sub-menu, set Files allowed per submission to One File, and Submissions to Only one submission allowed.

  5. Click Save and Close.

Stay notified when students submit

Email notifications can be generated whenever a student submits to an Assignment, which may actually be desired in this situation.

  1. Go to the Assignments tool.

  2. Click the drop-down arrow next to the Medical Self-Declaration Form Assignment and choose Edit Assignment.

  3. Go to the Submission & Completion sub-menu and find Notification Email at the bottom.

  4. Enter the Brock email address in the Notification Email field to where emails will be sent every time a student submits the Form.



Please contact CPI at edtech@brocku.ca with any questions or comments about the contents of this site.