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California State University, Bakersfield Office of the Registrar Mail Stop: 47 SA, 9001 Stock dale Highway Bakersfield, California 933111022 Tel. (661) 654.3036 | registrar@csub.eduREQUEST FOR MEDICAL
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How to fill out request for medical withdrawal

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How to fill out request for medical withdrawal

01
Obtain the request for medical withdrawal form from your school or medical provider.
02
Fill out your personal information including name, address, student ID number, and contact information.
03
Provide a detailed explanation of your medical condition and why you are requesting a withdrawal.
04
Attach any relevant medical documentation such as doctor's notes, test results, or hospital records.
05
Submit the completed form to the appropriate office at your school for review and approval.

Who needs request for medical withdrawal?

01
Students who are experiencing medical issues that are interfering with their ability to attend classes or perform academically.
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A request for medical withdrawal is a formal petition submitted by a student to withdraw from classes due to medical reasons.
Any student who needs to withdraw from classes due to medical reasons is required to file a request for medical withdrawal.
To fill out a request for medical withdrawal, students must provide documentation from a medical professional outlining the reasons for the withdrawal.
The purpose of a request for medical withdrawal is to formally request permission to withdraw from classes due to medical reasons and receive any necessary accommodations.
Information that must be reported on a request for medical withdrawal includes the student's personal information, details of the medical condition, and documentation from a medical professional.
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