Statement of hindrance request

Privacy

The university will handle your request strictly in accordance with the privacy regulations (GDPR). Your data will only be seen by staff of the Student Support Services.


When did this situation occur? You can state more than one period (maximum 4)
dd/mm/yyyy
dd/mm/yyyy
dd/mm/yyyy
dd/mm/yyyy
dd/mm/yyyy
dd/mm/yyyy
dd/mm/yyyy
dd/mm/yyyy

Before submitting this form, you are advised to do the following:

  • For medical issues: obtain a print-out of your medical dossier (which you are always entitled to) or a statement from your doctor.
  • For other circumstances: make an appointment with a student cousellor (see contact). In some cases he/she may be able to issue a statement for you. Only submit this form after your appointment. 
* = Input is required
 
The form cannot be opened. This form requires files to be attached. Unfortunately, the system that you use (Safari on iOS) does not support this.
Only the digits of your student number.
If your programme is not in this list, please select 'Programme not listed' at the bottom of the selection panel and declare the correct programme below, at the top of your description of your situation/cirmumstances.
 You can select more than one.
For example: study adviser, student counsellor, student psychologist 
You can upload max. 3 attachments