To support students taking time away from Dartmouth for medical reasons.
Dartmouth recognizes that students may experience health challenges that significantly impact their ability to function successfully or safely while engaging in their academic program at Dartmouth. In such situations, Dartmouth supports students to take time away so they may receive treatment beyond what can typically be provided or accessed while actively enrolled in an academic program. Students who wish to pursue Time Away for Medical Reasons, also referred to as TAMR, may do so voluntarily. In rare circumstances, Dartmouth may require a student to take TAMR. TAMR will not be deducted from the student's total allowable personal time away from their academic program.
Each Dartmouth school—Undergraduate Arts & Sciences, the Geisel School of Medicine, the Guarini School of Graduate and Advanced Studies, the Thayer School of Engineering, and the Tuck School of Business—has developed school-specific clarifications to address their unique academic requirements within this institutional policy. Students should contact the Office of Student Time Away or their School Contact (see the Roles and Responsibilities section of this policy) to get their school's most updated information. If a school-specific clarification conflicts with this institutional policy, Dartmouth shall act in accordance with this institutional policy. In Dartmouth's institutional policy and in each school policy, there is parity for students navigating physical and/or mental health challenges.
Dartmouth processes student requests related to taking TAMR in accordance with this policy and Dartmouth's Nondiscrimination and Anti-Harassment Policy and Resolution Procedures. Dartmouth prohibits unlawful discrimination on the basis of any type of Disability or any other characteristic protected by applicable law in the administration of Dartmouth's programs or activities. The options available under this policy help students receive an Individualized Assessment that is based on current medical knowledge, the best available objective evidence, administrative consideration, and the support services needed to address health issues that significantly interfere with students' ability to engage in academic, residential, and/or campus life. When warranted, Dartmouth will provide Reasonable Accommodations to Dartmouth's policies, practices, and procedures that are necessary to prevent discrimination unless the Reasonable Accommodations would fundamentally alter the nature of Dartmouth's academic standards, course requirements, goods, services, facilities, privileges, advantages, or Accommodations. Students with Disabilities may request Reasonable Accommodations by contacting their Dartmouth Disability Access Professional.
In emergency situations, Dartmouth may provide information to students' emergency contacts, including parents and/or guardians. Any information provided by Dartmouth in accordance with this paragraph shall follow the then-applicable legal requirements, as determined by Dartmouth.
Office of Student Time Away: The Office of Student Time Away supports undergraduate, graduate, and professional school students through all phases of the time away process, including taking time away, being away, and returning. Staff are available to provide resources, answer students' questions, and facilitate conversations with other areas at Dartmouth.
Director of Student Time Away or Director: The Director manages the Office of Student Time Away and any processes related to students taking time away, being away, or returning. The Director works closely with the student, the School Contact, the TAMR Committee, Licensed Clinicians, and others to ensure that student time away requests are processed in a timely and supportive manner according to this policy and any school-specific clarifications.
School Contact: School Contacts are staff members who support students in their engagement with their school's curriculum and in their overall educational experience at Dartmouth. School Contacts are available to discuss academic advising and personal issues with students. School Contacts make decisions about granting TAMR requests after considering the recommendations of the TAMR Committee.
TAMR Committee: The TAMR Committee reviews and gives recommendations on TAMR requests in order to facilitate consistent application of policies and processes. The Director of Student Time Away chairs the TAMR Committee.
Licensed Clinician: A Licensed Clinician is a health care provider, licensed in their area of practice, whose Clinical Assessment the TAMR Committee will rely on to inform their recommendation to the School Contact. A Licensed Clinician may practice within or external to the Dartmouth Student Health Service.
School Dean (or designee): The School Dean is the dean of a Dartmouth school who is responsible for decision-making related to required TAMR (see the Required Time Away for Medical Reasons section of this policy) and students' requests for appeals (see the Appealing Decisions section of this policy).
Provost (or designee): The Provost is responsible for institutional policies at Dartmouth and may become involved in decision-making related to required TAMR (see the Required Time Away for Medical Reasons section of this policy) or during an appeals process (see the Appealing Decisions section of this policy).
Students with questions about how taking TAMR might affect their time at Dartmouth or what resources are available to help them navigate their time at or away from Dartmouth can be in touch with the Office of Student Time Away or their School Contact for information.
The process for submitting a request to take TAMR begins with students contacting the Director of Student Time Away. The Director will review with the student the forms and Medical Documentation required and the process, including applicable deadlines and school-specific clarifications. The Office of Student Time Away can help facilitate conversations with other areas at Dartmouth, including with the student's School Contact, their Dartmouth Disability Access Professional, and, if applicable, the Office of Visa and Immigration Services.
The Medical Documentation required to complete a request must be submitted to the Office of Student Time Away by the student or their Licensed Clinician. If a student is not already seeing a Licensed Clinician, they can schedule an appointment with the Dartmouth Student Health Service. The Director of Student Time Away may request additional information. All requests for medical information will be limited to information that is reasonably necessary to resolve objective questions or concerns regarding the student's request. Medical Documentation held in the Office of Student Time Away is treated as confidential information; only the Director of Student Time Away, the Dartmouth Student Health Service, and others with a need to know will have access to Medical Documentation.
The Director will review TAMR requests with the TAMR Committee and will notify the School Contact of the TAMR Committee's recommendation. The School Contact will then determine whether to approve the student's TAMR request. Requests to take TAMR will be granted when it is determined that a student has a Significant Health Matter. TAMR is not applied retroactively (e.g., for a term prior to the current term).
If the student's request is granted, the Office of Student Time Away will facilitate conversations with the applicable areas at Dartmouth to help support the student's next steps.
Students have the opportunity to appeal their School Contact's decision according to the Appealing Decisions section of this policy. When communicating the decision, the student will be notified of (i) the reason for the decision; (ii) their right to appeal and to use Reasonable Accommodations during the appeal process; and (iii) the scope of their access, if any, to Dartmouth's campus or facilities during the appeal process.
Requiring a student to take TAMR is rare. Students who experience health conditions that cannot be addressed through Reasonable Accommodations and require a level of care that exceeds what Dartmouth can appropriately provide may be required to take TAMR by their School Dean or designee. If a student is enrolled in more than one school at Dartmouth, then the School Deans shall reach a joint decision. If the School Deans are unable to reach a decision, the Provost or designee shall make the final decision.
Dartmouth will require a student to take TAMR if the School Dean or designee determines that (A) the student has declined or neglected to take TAMR voluntarily after being offered the opportunity to do so, (B) the student has a Significant Health Matter, (C) no Reasonable Accommodations would permit the student to continue their studies or the student refuses Reasonable Accommodations that would be necessary for the student to continue their studies, and (D):
The decision that a student meets the standards set forth above will be based on an Individualized Assessment of the student's unique circumstances. The School Dean or designee will make a decision based on a reasonable judgment that relies on current medical knowledge or on the best available objective evidence, as informed by the recommendation of the TAMR Committee, in order to ascertain: the nature, duration, and severity of the risk or disruption; the probability that the risk or disruption will actually occur; and (as applied to the latter three bullet points above) whether reasonable modifications of policies, practices, or procedures will adequately mitigate the risk or disruption so as to eliminate the need for TAMR.
Notice. The School Dean or designee will notify the student in writing that a required TAMR is under consideration. The notice will explain the reason(s) why it is under consideration, the standards to be used to make that decision, contact information for the Dartmouth Disability Access Professional who can provide information about Reasonable Accommodations, and the process, including the right to appeal a decision. The student will be provided (i) contact information for the Director of Student Time Away and their School Contact who can answer questions about the process, and (ii) a copy of this policy. The student will be encouraged to respond to the identified reasons before a decision is made; the student will be given a specified period of time in which they can provide a response. The student may request Accommodations.
Evaluation of proposal to require TAMR. The School Dean or designee will refer the student for a Clinical Assessment by a Licensed Clinician to be completed within a reasonable timeframe established by the School Dean or their designee. Clinical Assessments may be completed by a Licensed Clinician at the Dartmouth Student Health Service and/or an agreed upon Licensed Clinician in the appropriate field of practice. In the latter case, the student will be asked to sign appropriate releases giving Dartmouth permission to provide their Licensed Clinician with any relevant information from the student's health care and/or administrative records to assist in their Clinical Assessment. The student will also be asked to sign a release permitting the Licensed Clinician to provide Medical Documentation that results from the Clinical Assessment to the Director of Student Time Away and the Dartmouth Student Health Service.
Medical Documentation held in the Office of Student Time Away is treated as confidential information; only the Director of Student Time Away, the Dartmouth Student Health Service, and others with a need to know will have access. All requests for medical information will be limited to information that is reasonably necessary to complete the Individualized Assessment (i.e., reasonably related to the circumstances and facts that pertain to possibly requiring time away from Dartmouth). If a student refuses to sign a release or respond within the timeframe set, the School Dean or designee may proceed with making decisions based on information in the School Dean's or designee's possession at the time.
Clinical Assessments should be based on reasonable judgment that relies on current medical knowledge or on the best available objective evidence in order to ascertain: the nature, duration, and severity of the risk or disruption; the probability that the risk or disruption will actually occur; and whether reasonable modifications of policies, practices, or procedures will adequately mitigate the risk or disruption so as to eliminate the need for requiring TAMR. Licensed Clinicians will consider relevant information provided to them when conducting their Clinical Assessment. If a Licensed Clinician at the Dartmouth Student Health Service determines that the Medical Documentation provided by a student's Licensed Clinician is incomplete, requires further explanation or clarification, or is inconsistent with other information in the student's record, the Licensed Clinician at the Dartmouth Student Health Service, with proper authorization, may contact the student's Licensed Clinician to obtain additional information. If the Licensed Clinician at Dartmouth Student Health Service believes it will facilitate a more informed decision, Dartmouth may ask the student to undergo an additional evaluation by an independent and objective professional designated by Dartmouth.
At the discretion of the School Dean or designee, and based on their Individualized Assessment of the facts of the student's situation, any pending disciplinary action based on the student's underlying behavior may be placed on hold until the Clinical Assessment is completed.
The Director of Student Time Away will review the Medical Documentation and other relevant information with the TAMR Committee and will notify the School Dean of the TAMR Committee's recommendation. The School Dean or designee may confer with other relevant sources, including a student's academic advisors, as the School Dean or designee deems appropriate. The School Dean or designee will give significant weight to the TAMR Committee's recommendations regarding the student's ability to function academically and safely at Dartmouth with or without Reasonable Accommodations.
Decision. The School dean or designee will make the final decision regarding TAMR, with due consideration given to relevant information received, including the recommendation of the TAMR Committee, information the student submits, and the analysis of possible Accommodations. The written notice of decision will include information about the basis for the decision.
If TAMR is warranted, the student shall be provided with: (i) a timeframe for if and when the student must leave Dartmouth; (ii) a timeframe for when the student may be eligible to return to Dartmouth and the conditions and/or requirements the student will need to satisfy to be eligible to return; (iii) the student's right to appeal and to use Reasonable Accommodations during the appeal process; and (iv) the scope of the student's access, if any, to Dartmouth's campus or facilities during the appeal process.
The length of the time away will be determined on an individual basis. The Director of Student Time Away will present written treatment recommendations from the Dartmouth Student Health Service to a student who is required to take TAMR; these recommendations are confidential and provided to the student and not the School Contact.
The process for returning after TAMR is outlined in the Return from Time Away for Medical Reasons section of this policy. The Dartmouth Student Health Service's assessment of the student's readiness to return will include a review of information from the student's Licensed Clinician(s) during the period of time away, which will focus on improvement of the clinical condition and readiness to return. The written notice of decision will inform the student of their right to request Reasonable Accommodations in the return process and contact information for the Dartmouth Disability Access Professional at their school who can answer questions about Accommodations as part of the return process.
If a student is not required to take TAMR, the School Dean or designee may impose conditions and/or requirements under which the student is allowed to remain at Dartmouth; if a student is unable or unwilling to meet these conditions and/or requirements, Dartmouth will determine how best to support the safety, health, and well-being of the community.
In lieu of Dartmouth requiring a student to take TAMR, a student may request to take TAMR at any time. In addition, requiring that a student take TAMR is not a disciplinary action. Separate disciplinary action may result from the underlying behavior of a student who is required to take TAMR, pursuant to the conduct standards in the applicable Dartmouth student handbook.
In situations involving an imminent or ongoing threat of harm to the student or any other member of the Dartmouth community, the School Dean or designee, in the exercise of their reasonable judgment, may require a student to be immediately prohibited from entering Dartmouth's campus or facilities used for Dartmouth programs or activities, or participating in Dartmouth-sponsored programs (such as study abroad), while an Individualized Assessment takes place. Such students will receive written notice and an opportunity to be heard as soon as reasonably possible, but no later than 30 calendar days after Dartmouth takes action.
The goal of TAMR, whether requested or required, is to support students to take time away to regain the level of wellness required to manage the academic and community obligations at Dartmouth. Before beginning TAMR, the student and Director of Student Time Away will discuss Dartmouth's recommendations for the student while they are away, recommendations that will be considered when reviewing the student's request to return.
While the student is away, the Director will maintain communications with the student to provide support, connection, and resources. Students on TAMR are able to use Dartmouth facilities like a member of the general public. For more information on services available to students on TAMR, read through the Office of Student Time Away's frequently asked questions.
When considering returning from TAMR, students should work closely with their Licensed Clinician(s) to gauge their readiness. Students should also ensure that all Dartmouth conditions and/or requirements for return are met and, if applicable, that the leave period designated in Dartmouth's notification of TAMR has elapsed.
The process for requesting to return TAMR begins with students contacting the Director of Student Time Away. The Director will review with the student the forms and Medical Documentation required and the process, including applicable deadlines and school-specific clarifications. The Office of Student Time Away can help facilitate conversations with other areas at Dartmouth, including with the student's School Contact, their Dartmouth Disability Access Professional, and, if applicable, the Office of Visa and Immigration Services.
The Medical Documentation required to complete a request must be submitted to the Office of Student Time Away by the student or their Licensed Clinician. If a student is not already seeing a Licensed Clinician, they can schedule an appointment with the Dartmouth Student Health Service. The Director of Student Time Away may request additional information. All requests for medical information will be limited to information that is reasonably necessary to resolve objective questions or concerns regarding the student's request. Medical Documentation held in the Office of Student Time Away is treated as confidential information; only the Director of Student Time Away, the Dartmouth Student Health Service, and others with a need to know will have access to Medical Documentation.
The Director will review TAMR requests with the TAMR Committee and will notify the School Contact of the TAMR Committee's recommendation. The School Contact will then determine whether to approve the student's TAMR request. Both the health of the student and the student's demonstrated ability to resume participation in all aspects of their academic and campus life are central to the decision of whether the request will be granted (with or without Reasonable Accommodations). Clinical improvement and the Medical Documentation provided by the student's Licensed Clinician(s) will weigh heavily in the consideration of a student's request to return. All returning students must meet the essential eligibility requirements, if any, to be a student at Dartmouth, and, if applicable, the relevant school or department, with or without Reasonable Accommodations.
If the student's request is granted, the Office of Student Time Away will facilitate conversations with the applicable areas at Dartmouth to help support the student's next steps.
Students have the opportunity to appeal their School Contact's decision according to the Appealing Decisions section of this policy. When communicating the decision, the student will be notified of (i) the reason for the decision; (ii) their right to appeal and to use Reasonable Accommodations during the appeal process; and (iii) the scope of their access, if any, to Dartmouth's campus or facilities during the appeal process.
Students have the right to appeal a decision made related to a request to take TAMR, a required TAMR, or a request to return from TAMR.
Requests for appeals must be submitted in writing within five business days after receiving notice of the decision, as detailed below. If a student has been required to take TAMR, that requirement remains in effect while the request for appeal is pending. If a student is asked to remain away from Dartmouth while the appeal is underway, the School Dean or designee will work to reach a decision within five business days, provided the student responds in a timely manner to requests for information, and, if appropriate, evaluation.
Students must submit their written appeal to their School Dean or designee. The appeal must include detailed support for the request to overturn or modify the decision; it must specify the substantive and/or procedural basis for the appeal and must be made on grounds other than general dissatisfaction with the School Contact's decision. The review of the appeal by the School Dean or designee will be limited to the following considerations:
In determining whether to grant the appeal, the School Dean or designee may meet with the student and/or confer with other relevant sources as the School Dean or designee deems appropriate. The School Dean or designee shall issue a written decision affirming, modifying, or reversing the initial decision. The decision of the School Dean or designee is final; no other appeals or grievance procedures are available.
The School Contact who made the initial decision that is being appealed shall not hear the student's appeal. If the School Dean made the initial decision, the Provost or designee shall hear the student's appeal. If a student is enrolled in more than one school at Dartmouth, then the School Deans shall reach a joint decision. If the School Deans are unable to reach a decision, the Provost or designee shall make the final decision.
Nothing in this policy limits the power of Dartmouth to take administrative action to ensure the safety of the Dartmouth community.
This institutional policy and process applies to all students at Dartmouth. This institutional policy and process may be revoked or amended by Dartmouth, in whole or in part, from time to time, via the Provost, who is authorized to make revocations or amendments on behalf of Dartmouth, in consultation with Dartmouth's senior leadership group. Any such revocation or amendment shall become effective upon adoption by the Provost, or as of such other time as the Provost shall specify and will be reflected in the current version of the institutional policy and process posted within Dartmouth's Policy Portal. Questions or disputes regarding the application, interpretation or implementation of this institutional policy and process shall be resolved by the Provost; the decision of the Provost on the matter shall be binding on Dartmouth and all individuals subject to this institutional policy and process.
"Accommodations" and "Reasonable Accommodations" are defined by applicable legislation, including the Americans with Disabilities Act (42 U.S.C. § 12101, et seq.) and Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 701, et seq.), as amended, and the regulations implementing such legislation. The Americans with Disabilities Act or ADA is the federal law, as amended, that protects individuals with Disabilities from discrimination in any program or activity for which they are qualified to participate. The Rehabilitation Act of 1973 is the federal law, as amended, that states, in relevant part, "no qualified individual with a disability in the United States shall be excluded from, denied the benefits of, or be subjected to discrimination under" any program or activity that receives federal financial assistance.
"Clinical Assessment" means an objective health assessment performed by a Licensed Clinician for a student with a health condition.
"Disability" means, with respect to an individual:
"Individualized Assessment" means the process of assembling the pertinent facts and factors related to decision-making about a student's TAMR. Individualized Assessments are based on current medical knowledge, the best available objective evidence, administrative consideration, and the support services needed to address health issues that significantly interfere with students' ability to engage in academic, residential, and/or campus life.
"Medical Documentation" means an official communication from a Licensed Clinician in the area of specialty for a student's health condition.
"Significant Health Matter" means a permanent or temporary medical condition that interferes with a student's ability to (i) consistently perform activities of daily living, (ii) fully engage, participate in, and meet academic requirements, or, (iii) requires levels of care beyond what Dartmouth offers or is equipped to reasonably provide.
"Time Away for Medical Reasons" or "TAMR" means a period of time away from Dartmouth programs for a student at any Dartmouth school due to a Significant Health Matter.