Reinstatement Supplemental Information Form for Leave of Absence 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the top section with your personal information, including your name, date of birth, UMID, and uniqname. This ensures that your application is correctly identified.
3. Authorize your health care provider to share necessary medical information by signing in the designated area. This consent is crucial for facilitating your return.
4. Next, provide the form to your health care provider. They will need to complete their section, detailing diagnoses, treatment plans, and any restrictions on your activities.
5. Once completed, ensure that the health care provider submits the form directly to Rackham Graduate School via fax or mail as indicated.

Start using our platform today to easily fill out and submit your Reinstatement Supplemental Information Form for free!