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Request for Medical Withdrawal

What you need to know:

  1. If requesting to withdraw from classes with a refund, the appropriate form to complete is the Tuition and Fees Refund Appeal Application. Please refer to that form for guidelines, requirements and the appeal review process.
  2. All requests for a medical withdrawal must be submitted no later than 30 calendar days from the last day of the semester for which the withdrawal is desired.
  3. Your request will be reviewed once we have received the Request for Medical Withdrawal Form and supporting documentation.
  4. Your request will be reviewed within one week. After a decision has been made, we will contact you via email. (The entire process, including the removal of your classes, could take up to two weeks)
  5. Your request only impacts the most recent semester. Therefore, if you are enrolled for the following semester, and believe your medical condition will impact your success, then, you are responsible for dropping the courses via the online student center before the start of that semester.
  6. In the event of a student death, this form can be completed by an immediate family member over the age of 18. An immediate family member is defined as a parent, spouse/partner, child, and/or sibling.

Instructions to Student:

  1. Complete the Request for Medical Withdrawal (on the backside of this form)
  2. Attach supporting documentation. Examples of supporting documentation include, but are not limited to the following, a letter from health care provider explaining the general nature of medical condition and dates in which the medical condition occurred.
  3. If you received Financial Aid, you are required to consult with a Financial Aid staff member to determine the Financial Aid impact. This form will not be processed if you received Financial Aid and there is not a signature of an authorized staff member.
  4. Return form to the Associate Dean of Student Success and Retention Office; 347 Student Center.

Please note: If you are a financial aid recipient, you should contact the Financial Aid Office first before dropping the course. Your current and future financial aid could be severely impacted by dropping courses after the semester has started. The Financial Aid Office can be reached at 616.234.4030. If you are on academic probation, you should also consult with an academic advisor before you drop a course. Dropping a course can place you on Academic Suspension. The Counseling and Career Center can be reached at 616.234.3900.