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Medical/Compassionate Withdrawal

The student must initiate the withdrawal in the same manner as all other withdrawals and must completely withdraw from all classes through the Records Office. When this is complete, the student may then apply for a medical withdrawal. A medical withdrawal is not designed for financial purposes but is designed to allow the student to withdraw in good academic standing with the University. The student's tuition will be adjusted based on the regular refund guidelines based on the date the complete withdrawal form is received by the Records Office. Any additional adjustments to tuition charges must be authorized by the Director of Student Accounts in conjunction with the Director of Financial Aid if applicable. The following procedure applies to students who are unable to continue classes for extraordinary medical or other personal reasons. You are encouraged to submit your applications as soon as possible.

NOTE: If you are receiving financial assistance, you are encouraged to consult with Student Accounts and Financial Aid to identify and understand the financial assistance/monetary implications of processing this withdrawal transaction.

To process a medical/compassionate withdrawal, you must complete the following steps: Submit the Medical/Compassionate Withdrawal request form to the Saint Martin's University Registrar. Provide appropriate documentation. For a medical withdrawal, provide a letter from your attending health care provider that specifies the date of onset of illness, the dates you were under professional care, the general nature of your medical condition and why/how it prevented you from completing your course work, the date of your anticipated return to school, and the last date you were able to attend class. Requesting for less than a complete withdrawal must be especially well documented to justify the selective nature of the medical/compassionate withdrawal request. The letter must be typed on the health care provider's letterhead stationery and submitted in a sealed envelope. For a compassionate withdrawal, provide the documentation that is appropriate to your circumstances. (For example, a compassionate withdrawal request to care for a seriously ill child or other family member may require information similar to that listed under medical withdrawal above. Depending on the situation, other required/acceptable documentation may include police reports, legal documents such as restraining orders, airline ticket receipts, newspaper clipping, etc.)

University procedures for Medical/Compassionate Withdrawal: Registrar accepts a completed request for Medical/Compassionate Withdrawal to include a letter from the attending health care provider, or other appropriate documentation. Registrar reminds the student to discuss the implications of this request with Student Accounts and Financial Aid, if he or she is receiving financial assistance. Registrar forwards request to the Vice President of Academic Affairs (VPAA) and Dean of Students for final approval. The VPAA's Office will send a letter to student accepting or denying the application with explanation. If approved, the student's letter must be copied to Student Services, Registrar, Financial Aid, and Student Accounts. Records will be maintained in the Registrar's office.

Request for Medical/Compassionate Withdrawal from Saint Martin's University

(Withdrawal through Registrar required)

Name Permanent Address City Major or Department Period for which medical/compassionate withdrawal is requested: Fall 20 Spring 20 Summer 20 State Zip

SMU ID Phone Email

If you are an extension campus student (Fort Lewis/McChord), circle Term also: Date you last attended class for the period:

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2

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Please use the space below to describe the circumstances pertaining to your request. (Attach or send separately medical documentation (hospital summary, physician notes) or a letter from your physician or counselor. Address the letter to Mary Law, Registrar. Be sure to keep copies of all documentation sent to us or have your physician send you a copy of any records sent to us. You may need these copies of documentation for Student Accounts or Financial Aid appeals)

I hereby petition for medical or compassionate withdrawal from Saint Martin's University due to the illness, disability or extreme personal reasons described below. I authorize relevant SMU personnel to review any medical records or other related documentation necessary to determine my eligibility for a medical withdrawal, financial aid status, and/or refund.

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Date

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