Medical/Compassionate Withdrawal Instructions


 A medical withdrawal may be requested when extraordinary circumstances, such as a serious illness or injury, prevent the student from continuing classes.  This policy covers both physical-health and mental-health difficulties. 

 A compassionate withdrawal may be made in extraordinary cases in which a significant personal situation, (for example, the serious illness of a child or spouse or the death of a parent, child or spouse) prevents a student from continuing in classes.

 Medical/compassionate withdrawals may be considered when incompletes or other arrangements with instructors are not available, or when restricted withdrawals and other enrollment options are not possible.

All requests require thorough and credible documentation.  Generally, students request a complete withdrawal from semester coursework. Application for a parital withdrawal must be specifically documented to justify the selective nature of the request.   It is your responsibility to insure appropriate forms and documents are included and complete.  However, completing the process does not guarantee or ensure approval; each case is reviewed individually.   The medical designee may seek additional information from you, from your instructors or from those providing the documentation.  Verification of authenticity of documentation is standard practice. 

 If you are receiving financial assistance, you are strongly encouraged to consult with a Student Financial Assistance Counselor to identify and understand the financial assistance / monetary implications of processing this withdrawal transaction.

Submission of Medical/Compassionate Withdrawal Materials


College of Integrative Sciences and Arts: Medical Designee Information  
Lorraine DeRosa
CISA Academic Advising (480) 965-4464


Instructions:  Click on the Request for Documented Medical/Compassionate Withdrawal Form below, to access the request form.  Download the PDF form,  save, and then open to enter  information on the fillable PDF form.  Once completed,  save the form and email to .Students should also attach a personal statement and any relevant documentation to the email.   

If you are unable to access the form , please email the Medical Designee for additional instructions.  



Request for Documented Medical/Compassionate Withdrawal Form

  • If requesting a Medical/Compassionate Withdrawal for more than one semester, each semester of coursework must be on a separate form.  
  • The top of the form(s) must be completed and signed by the student. If the student is physically unable to do so, a parent, spouse or other representative may complete the process for them. 
  • Write a brief statement outlining the reason for your request.
  • The medical designee reviewing the request may seek additional information.

Medical Withdrawal Documentation

  • Include a scanned letter, on letterhead, from your health care provider with your submission.  Your letter should include the following:
    • Date of the onset of the illness
    • Dates of medical care
    • General nature of your medical condition and how/why it prevented completion of your course work
    • Date of your anticipated return to school
    • Last day you were able to attend class

Medical and Compassionate Withdrawal Submission

Before submitting a medical compassionate withdrawal request, please review the directions.