To submit a request in the Medical Leave and Return Process, complete the following form, upload the appropriate Treatment Provider Form, and then monitor your email for further instructions.

Student Request Form

Request types included on the Student Request Form:

  • Medical Leave - Current Term
  • Medical Leave - Previously Completed Term
  • Return from Medical Leave

Medical Leave: 

Complete Part 1 of the Treatment Provider Form. Contact your licensed medical treatment provider to complete Part 2. Upload the completed form to your Student Request Form.

Return from Medical Leave:

Complete Part 1 of the Assessment and Recommendation for Return from Medical Leave Form. Contact your licensed medical treatment provider to complete Part 2. Upload the completed form to your Student Request Form.