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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 situation 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 that substantiates medical claims that interfered with class attendance and/or academic success. Examples include, but are not limited to: (medical forms indicating hospitalization or decreased capacity to complete coursework, legal documents indicating short-term incarceration, obituaries or other documents indicating death of immediate family member, or documents indicating homelessness (i.e. eviction notice, housing voucher from a housing commission, etc.)

  3. If you received Financial Aid, you should consult with a Financial Aid staff member to determine the Financial Aid impact. There may be a negative impact on your financial aid if you withdraw from a class that has already begun.
  4. Return form to the Associate Dean of Student Success and Retention Office; 347 Student Center.
  5. If you have any questions, please call 616-234-4839.

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.