Withdrawal medical form 2026

1. Click ‘Get Form’ to open the Catastrophic Withdrawal Request – Medical form in the editor.
2. Begin by completing Part I of the form. Fill in your last name, first name, campus ID number, email address, street address, city, telephone number, and indicate if you hold an F1 or J1 visa. Select the term for which you are requesting a withdrawal.
3. Carefully read the statements provided before signing. Ensure you understand the implications of your request on financial aid and academic records.
4. In Part II, have your health care provider complete their section. They will need to provide details about your medical condition and its impact on your studies.
5. Once both parts are completed and signed, submit the form via fax or mail to Enrollment Services before the deadline.

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