Get the free Medical Withdrawal Form - Community College of Allegheny County - ccac
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FALL 2013 COMMUNITY COLLEGE OF ALLEGHENY COUNTY Supportive Services CCC Allegheny Campus 808 Ridge Ave Pittsburgh, PA 15212 pH: 412.237.4612 Fax: 412.237.2721 Supportive Services CCC Boyce Campus
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How to fill out medical withdrawal form
How to fill out medical withdrawal form:
01
Obtain the medical withdrawal form from the appropriate department or office. This may be the student affairs office, health services office, or registrar's office at your educational institution.
02
Read the instructions carefully. Familiarize yourself with the requirements and any supporting documents that may be needed.
03
Fill out the personal information section of the form, including your full name, student ID number, contact information, and the dates of your enrollment.
04
Provide a detailed explanation of the medical condition or reason for your withdrawal. Be specific and provide any relevant medical documentation or letters from healthcare professionals supporting your request.
05
Indicate whether you are requesting a complete withdrawal or a partial withdrawal from specific courses. If you choose a partial withdrawal, specify the course codes and titles.
06
If applicable, provide supporting documentation such as medical records, doctor's notes, or any other evidence that validates your medical condition.
07
Sign and date the form. Make sure to review all the information you have provided for accuracy before submitting it.
08
Submit the completed form to the designated office or department. Check their specific submission requirements, as some may require in-person submission, online submission, or mailing it to a specific address.
Who needs a medical withdrawal form:
01
Students who are experiencing a severe medical condition that prevents them from continuing their studies may need a medical withdrawal form.
02
Students who require an extended period of medical leave or treatment that will interrupt their academic progress may need to complete a medical withdrawal form.
03
Students who are advised by healthcare professionals to take a temporary or permanent break from their studies due to health-related reasons may need to go through the process of obtaining a medical withdrawal form.
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What is medical withdrawal form?
The medical withdrawal form is a document used to officially withdraw from a course or program due to medical reasons.
Who is required to file medical withdrawal form?
Any student who wishes to withdraw from a course or program due to medical reasons is required to file a medical withdrawal form.
How to fill out medical withdrawal form?
To fill out the medical withdrawal form, you need to provide your personal information, such as name and student ID, as well as details about your medical condition and the courses/programs you wish to withdraw from.
What is the purpose of medical withdrawal form?
The purpose of the medical withdrawal form is to officially document and request the withdrawal from a course or program due to medical reasons.
What information must be reported on medical withdrawal form?
The medical withdrawal form typically requires information such as your personal details, the medical condition or reasons for withdrawal, and the courses/programs you wish to withdraw from.
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