Umm Al-Qura University

Umm Al-Qura University

Form to Request Medical Enquiry about a Student’s Status

Form to Request Medical Enquiry about a Student’s Status

From : - 2020/08/19 م , To : - 2050/08/24 م

There is a saved copy of this form. Do not forget to submit the form after completing all the required fields to reset the saved form. Click here

Form to Request Medical Enquiry about a Student’s Status

* Academic Year

السنة الدراسية الثانية السنة الدراسية الثالثة السنة الدراسية الرابعة السنة الدراسية الخامسة السنة الدراسية السادسة

* College

Select Department

* Name of the Hospital

* I, the student, acknowledge that I filled in the form and pledge that all the information stated and documents attached are correct.

I, the student, acknowledge that I filled in the form and pledge that all the information stated and documents attached are correct.

Human Verification Tool

Loading