Required documents
Request for Documented Medical/Compassionate Withdrawal Form
Download and enter your information on the Request for Documented Medical/Compassionate Withdrawal Form. Once completed, save the form and email the document to cisamcw@asu.edu.
If requesting a medical/compassionate withdrawal for more than one semester, each semester of coursework must be on a separate form.
It is the student's responsibility to ensure appropriate forms and documents are included and complete. Forms may be returned if the information submitted is inaccurate or the form is incomplete.
View Medical/Compassionate Withdrawal Form
Additional supporting documents
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.
Special considerations
Students receiving financial assistance
Students receiving financial assistance 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 at https://students.asu.edu/contact/financialaid.
Students receiving military benefits
Students receiving veterans’ benefits must contact the Pat Tillman Veterans Center (PTVC) regarding any impact of a medical/compassionate withdrawal to benefits or eligibility at PTVC@asu.edu
International students
If you are an international student with an F-1/J-1 visa, you must consult with the International Students and Scholars Center to discuss the serious immigration consequences that may result from your withdrawal from ASU. As an international with an F-1/J-1 visa, you must provide medical documentation from a licensed medical doctor, doctor of osteopathy, licensed clinical psychologist, psychiatrist or licensed psychologist. If you are an international student seeking a medical withdrawal for the current semester, you will also need to complete this form for the ISSC.
Graduate students
If you are a graduate student, there may be additional implications based on your student status and program. We recommend contacting your school/program advisor to discuss the impact of an MCW on your academic progress and record.