Forms

The following files are in PDF format. A free PDF reader, Adobe Acrobat, is available for download.

• Health Report

• Application for the Learning Disabilities Program

• Release of Medical Records form

• Meningitis Waiver

Medical Leave of Absence Forms 

A Medical Leave of Absence (MLOA) is an option to consider when a student is diagnosed with a major medical illness, injury, or psychiatric illness, after the start of the term that significantly interferes with his or her ability to attend classes and complete requirements. Medical leave petitions must be initiated through University Health and Counseling Services by sending a completed request form.
Return to classes following a MLOA requires a completed request for re-entry at UHCS no sooner than four, nor later than two, weeks prior to the start of classes.

Forms (PDF):

• Request for Medical Leave of Absence

• Request for Re-entry from Medical Leave of Absence