Leave of Absence Request

Policy: The Graduate Leave of Absence Policy assists graduate students who must temporarily withdraw from their programs. Reasons for requiring a leave typically include bereavement, illness, caregiving, maternity, paternity, and call to active military duty. Students who are granted a leave of absence are declared inactive but not dismissed from the university; however, being declared inactive may affect loans or financial aid, health insurance, and access to university resources, including libraries, computers, the Wellness Center, advising services dissertation/thesis committees, and other resources. Note: Do not provide private medical information due to the HIPAA Privacy Rule.

Eligibility: A Leave of Absence is granted only to students who a) have completed at least one full semester at the University of the Incarnate Word and are in good academic standing, with a minimum GPA of 3.0, and b) are in good administrative standing, as defined by the criteria of continuous enrollment and the Masters or Doctoral program continuation criteria.

Types of Leave

Military Leave: A student who must interrupt study temporarily to fulfill a compulsory military obligation for a specific time will be granted a military leave of absence to fulfill that obligation.
Maternity and Paternity Leave: Students who must temporarily interrupt study because of the birth of a child, adoption, foster care, or any related conditions may be granted a maternity and paternity leave of absence.

Medical and Compassionate Leave: A student who must interrupt study temporarily because of physical or psychological illness or care for a family member due to health or medical issues may be granted a medical and compassionate leave of absence.

Personal Leave: Students who must interrupt study temporarily for reasons other than those described above may request a personal leave of absence. Reasons may include financial status or other critical matters in one’s family, changes in one’s outside employment, and other situations.

Full Name*

First NameMiddle NameLast Name

Phone Number*

The best contact number for you

Student Email Address*

example@uiwtx.edu

PIDM*

Please enter your student ID

Select your current program*

Advisor Email Address

This email will receive this request

Type of Leave Requested*

Military Leave of AbsenceMedical and Compassionate Leave of AbsenceMaternity and Paternity Leave of AbsencePersonal Leave of AbsenceFinancial Hardship

Type of Leave Requested

Military Leave of AbsenceMedical and Compassionate Leave of AbsenceMaternity and Paternity Leave of AbsencePersonal Leave of AbsenceAcademic: Interruption in continuous enrollment due to academic challenge or obstacle

When will you begin your leave? *

Month and Year

When do you expect to return?*

Month and Year

How long will you be away from your program?

1 semester2 semesters1 yearUnknown

IMPORTANT: If you are absent for over 12 months, you must reapply for admission to your graduate program. If less than 12 months, you should use our Readmission form when you are ready to return.

Documentation supporting leave if applicable. NOTE: Due to the HIPAA Privacy Rule, do not provide private medical documentation with this form.

Do you authorize UIW to administratively withdraw you from the semester/s you will be away?*

YesNoI have already withdrawn or dropped all classes

Student Signature *

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