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Medical Withdraw from the University

Our role is to collect, review, and verify the documentation that you submit supports your request for a Medical or Mental Health Withdrawal. UTSA Counseling and Mental Health Services and UTSA Student Health Services will maintain the privacy of your documents throughout this review process. UTSA Counseling Services and Mental Health Services and UTSA Student Health Services will submit a recommendation to the M/MH Committee after all the documentation has been received and verified. The M/MH Committee will make the final decision regarding each student’s Medical or Mental Health Withdrawal request.

Medical/Mental Health Withdrawal Request Guide and Checklist - This document is the cover letter, explaining the reasoning behind all of the Medical/Mental Health Withdrawal Documents. This document is a checklist to ensure you have everything you need for a Medical/Mental Health Withdrawal.

Authorization To Release Records and Information For Medical/Mental Health Withdrawal Request - These documents allows UTSA Counseling and Mental Health Services and/or Student Health Services permission to act on your behalf with the necessary UTSA Departments and to contact your medical provider for the purpose of your Medical/Mental Health Withdrawal.

Informed Consent: Medical/Mental Health Withdrawal Requests - These documents provides explanations of confidentiality, maintenance of records, services offered, and emergency/after-hours resources.

Personal Statement - This document has instructions on typing a personal statement regarding why you're requesting a Medical/Mental Health Withdrawal.

Medical Provider Statement - This document has instructions for your medical provider on how to provide a statement describing why you need a Medical/Mental Health Withdrawal.

Transcript - A current transcript (i.e. can be an unofficial copy) with the final grades earnedduring the semester in which you are applying for the Medical or Mental Health Withdrawal.Transcripts can be requested by accessing the Registrar’s Office online at

Medical/Mental Health Withdrawal Policy Information