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Medical/Compassionate Withdrawal Instructions

PLEASE READ CAREFULLY

 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.  Usually, consideration is for a complete withdrawal; application for less than a complete withdrawal must be especially 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.

The following items are required for consideration of this request:

 Incomplete requests will significantly delay the reviewing process.

Submission of the Packet

This completed packet should be submitted in person to 651 East University Drive by mail, or by fax, or email.  

College of Integrative Sciences and Arts: Medical Designee Information
Lorraine DeRosa, Office SupervisorLorraine.DeRosa@asu.edu
CISA Academic Advising(480) 965-8849
651 East University DriveFax # 480-727-6156
ASU Mail Code 0604
Tempe, AZ 85281-0604

REQUIRED DOCUMENTS

Request for Documented Medical/Compassionate Withdrawal Form

  • The top of the form 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. 
  • Please make sure to fill in the last day attended box on the request form.
  • Write a brief statement outlining the reason for your request.
  • The medical designee reviewing the request may seek additional information.

Medical Withdrawl Documentation

A letter, on letterhead, from your health care provider must be submitted in a sealed envelope or mailed directly to the medical designee.  The letter must include the following information:

  • 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 date you were able to attend class