Medical/Mental Health Withdrawal

Medical Withdraw from the University

Our role is to collect, review, and verify the documentation that you submit supporting your request for a Medical or Mental Health Withdrawal. UTSA Wellbeing Services will maintain the privacy of your documents throughout this review process. UTSA Wellbeing 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 Policy

  • Medical/Mental Health Withdrawal Application

    This document is the entire application in one .pdf.

    See the below bulletpoints, if you wish to know the description of each page of the form

  • 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    allow UTSA Wellbeing 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    provide 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 earned during 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  .