Return from a Leave of Absence

Students returning from an approved leave of absence should submit this form no later than July 15, if they plan to return for the fall semester, and no later than December 1, if they plan to return for the spring semester. Students returning from a medical leave must also submit to Columbia Health a letter from the health-care professional who provided treatment for the condition that occasioned the leave. See below for further instructions.

The complete policy regarding returning from a leave of absence is available online here.

Students who have decided not to return from a leave of absence should select the appropriate box below, indicating that they intend to withdraw from the University. The complete policy regarding withdrawals is available online here.

PERSONAL INFORMATION

LAST NAME:

FIRST NAME:

CITIZENSHIP OR VISA STATUS:

COLUMBIA (UNI) EMAIL ADDRESS:

NON-COLUMBIA EMAIL ADDRESS:

CUID/PID:

COO

(Refer to SSOL)

DEPARTMENT OR PROGRAM:

M.A. Programs:

Ph.D. Programs:

Dual-Degree Programs:

INFORMATION ON LEAVE OF ABSENCE

CATEGORY OF LEAVE:

MedicalMilitaryPersonal

SEMESTER(S) and YEAR(S) OF LEAVE:

SEMESTER AND YEAR OF PROPOSED RETURN:

OR:

I have decided not to return from my leave of absence; please withdraw me from my program.*

*Please note that the decision to withdraw is final. By selecting this option, you are officially notifying the Office of Student Affairs that you are withdrawing from your program.

FOR STUDENTS ON MEDICAL LEAVE: Please submit a letter from the health-care professional who provided treatment for the condition that occasioned the leave. You will not be able to register until you do so.

Letters must contain the following information:

Description of treatment the student received, including medications the student was prescribed for the condition that warranted the leave
The health-care professional's impression regarding the student's readiness to return to his or her studies
Any recommendations regarding continued treatment after the student has resumed his or her studies

Letters addressing psychiatric or psychological conditions should be sent to Dr. Allan Cassorla by fax (212-854-9473) or email (aac4@columbia.edu). Letters addressing medical conditions should be sent directly to Dr. Brenda Aiken by email (ba220@columbia.edu).

In cases where a student has received both medical and psychiatric/psychological treatment, or the diagnosis is unclear, the relevant health-care professional(s) should submit their letter(s) to both Dr. Cassorla and Dr. Aiken. Letters written in a language other than English must be accompanied by an English translation. All letters supporting a student's return must be sent no later than July 29 for students planning to return in the fall semester, and no later than December 15 for students planning to return in the spring semester.

ADDITIONAL INFORMATION OR COMMENTS

SIGNATURE OF STUDENT

DATE

Please save the email confirmation you will receive after you submit this form as documentation of your having submitted this request.

Once your request has been processed, you will receive an official communication from the Office of Student Affairs regarding the remaining steps necessary for your return.

You may contact the Office of Student Affairs with questions at gsas-studentaffairs@columbia.edu or (212) 854-8903.

Contact Information