Undergraduate Education
Withdrawal and Readmission
Telephone: (518) 442-3950
LC-30
Albany, New York 12222
Fax: (518) 442-4959
MEDICAL/PSYCHOLOGICAL WITHDRAWAL INFORMATION
If you are leaving the University for medical/psychological reasons, you should be aware of the following:

Immediately upon your decision to leave, you must complete a withdrawal form in the Office of the Vice Provost for
Undergraduate Education. If you are unable to accomplish this in person, a telephone call to this office will suffice in
order to begin the process.
Please note: The withdrawal form will be processed immediately upon receipt, pending a recommendation from
Student Health Services or Counseling and Psychological Services.

Either Counseling and Psychological Services or Student Health Services provides recommendations to the University
for action on medical/psychological withdrawals. In order to be evaluated for a medical withdrawal, a student must
provide the following information to the appropriate Center’s director:
1. A dated request for withdrawal. Forms are available from the Office of the Vice Provost for Undergraduate
Education.
2. Documentation completed and signed by a licensed health professional or treatment facility. Incomplete
information will delay action on the request.
Please provide the following:
a. Number of assessment/treatment sessions along with beginning and ending dates.
b. DSM-IV diagnosis including GAF.
c. An abbreviated mental status exam stating the impact of mental status on academic functioning.
d. An explicit recommendation for a medical withdrawal from a licensed health care professional.
 Please Note: Supporting documentation is maintained in confidential Counseling and
Psychological Services files or Student Health Services files and is not forwarded with the
recommendation.

This supporting medical documentation must be sent or faxed within no more than 15 calendar days directly to either
the Student Health Services or Counseling and Psychological Services (whichever would address the type of
difficulty you are experiencing and/or where you have been receiving treatment). IT IS YOUR RESPONSIBILITY
TO MAKE CERTAIN THAT THE INFORMATION IS SENT AND RECEIVED. The addresses are as follows:
Director of Student Health Services
400 Patroon Creek Blvd.
Suite 200
Albany, New York 12206
Telephone: (518) 442-5454
Fax: (518) 442-5444
Director of Counseling and Psychological Services
400 Patroon Creak Blvd.
Suite 104
Albany, New York 12206
Telephone: (518) 442-5800
Fax: (518) 442-3096
 FAILURE TO ACT WITHIN THE 15 CALENDAR DAY DEADLINE WILL RESULT IN THE
PROCESSING OF A NON-MEDICAL WITHDRAWAL.
 A confirmed medical withdrawal effective on or before the mid-semester point may qualify you for
tuition and fee adjustments as well as University housing charge adjustments for the term of
withdrawal. Whenever a student does not complete the semester, the financial aid package must be
recalculated. Federal regulations dictate the formula used in the return of federal Title IV financial
aid as a result of withdrawal. The amount of aid earned is based on the date of the student’s
withdrawal from the University. Withdrawing students with federal aid may have a portion of their
aid returned to the aid program, thus reducing the original amount of aid awarded. Therefore,
Student Financial Services suspends all financial aid refunds during the period of time in which you
are making arrangements to provide medical documentation. Please contact the Student Financial
Center (518) 442-3202 if you have questions regarding the impact of your withdrawal on your
financial aid package. A student may also owe repayment of a portion of the aid they have received
for off-campus expenses. For any questions related to Housing please contact Residential Life at
(518) 442-5875.
READMISSION
Counseling and Psychological Services or Student Health Services provides recommendations to the University for action
on readmission following a medical/psychological withdrawal. In order to be evaluated for readmission the student must
provide the following to the appropriate Center’s director who is responsible for determining that a student is fit for
readmission to the University.
1. A request for readmission. Matriculated undergraduates must complete an online readmission application.
http://www.albany.edu/undergraduateeducation/readmission.php
2.
Documentation completed and signed by a licensed health professional including:
a. Number of treatment sessions along with beginning and ending dates.
b. DSM-V diagnosis including current GAF.
c. An abbreviated mental status exam. Mental status deficits as they pertain to academic functioning must be
addressed.
d. An explicit recommendation for a medically cleared readmission by the licensed health care professional.
3.
Once Counseling and Psychological Services or Student Health Services has recommended readmission the hold
placed on your registration will be removed.
Making false statements and/or filing forged documents and/or submitting false material to a University committee
violates the standards of integrity. Such violations are subject to appropriate disciplinary action.
If you have questions, please contact this office at (518) 442-3950 or in LC-30.
Updated: 4/1/2016