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Reenrollment Following Medical Withdrawal

Student Request to Return from a Voluntary Medical Withdrawal

This form is for students who have specific return conditions identified in their original voluntary medical withdrawal determination from the OLR.

When a you are ready to return from a medical withdrawal, you must notify the university of your intent to return by submitting this form to OLR. Please reference the original determination letter you received for specific return requirements which may include, but are not limited to, a formal release from your treating provider that answers questions specific to the returning to the learning and living community at the University of Dayton.

Cost of Medical Records

Costs associated with voluntary medical withdrawal process, including copies of documentation from the provider, are your responsibility.


Student Information

Return Information from Medical Withdrawal

Form Completion Information

By completing this form, you acknowledge the requirement for your medical provider to submit a release on signed and dated letterhead. This release must address specific information about your readiness to return to the University of Dayton, which is primarily a residential environment where students take 12-18 credit hours per term and where you must be able to care for yourself and follow the University Code of Conduct. Please print and complete the Request for Return from Medical Withdrawal Documentation form at


Office of Learning Resources

Roesch Library
300 College Park
Dayton, Ohio 45469 - 1302