Going on or Returning from Medical Leave
Undergraduate Students
Going on Medical Leave
Undergraduate Deans' Office
If you need to take a medical leave from the Institute, you must petition through the Undergraduate Deans' Office. Please thoroughly read through the Undergraduate Deans' Office's policy, and complete the requested forms in a timely manner.
Student Wellness Services
To complete your petition to take leave, you will need the recommendation of either the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Please complete all the steps below in order after connecting with the Undergraduate Deans' Office.
Step 1: Release of Information and Records Consent Form
Complete the Release of Information and Records Consent Form for Student Wellness Services to coordinate with the Deans' Office. Please send us a secure message with the attachment via the Student Health Portal.
Step 2: Schedule an Appointment
Contact us at (626) 395-8331 and request an appointment with either the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Same-day appointments are unavailable and appointment slots are limited, so please plan ahead and send the completed form promptly.
Returning from Medical Leave
Dean of Undergraduate Students
If you are planning to return from medical leave, you must submit the Undergraduate Student Return from Leave Form 6 weeks before the first day of the term for which you intend to return.
Student Wellness Services
To complete your petition to return from leave, you will need the recommendation of the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Please complete all the steps below in order, 6 weeks prior to your return.
Step 1: Release of Information and Records Consent Form
If you don't have an active Release of Information and Records Consent Form for (1) the deans' office or (2) each provider you were under the care of, please send us a secure message with the attachments via the Student Health Portal.
Step 2: Provider Report Form
Request that each of your providers mails or faxes the completed Provider Report Form to our office. Our mailing address and fax number are provided at the top of the form. These forms should be dated around 6 weeks prior to your start date.
Step 3: Schedule an Appointment
After all forms have been submitted to our office, contact us at (626) 395-8331. Request an appointment with the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Same-day appointments are unavailable and appointment slots are limited, so please plan ahead and send completed forms promptly.
Graduate Students
Going on Medical Leave
Graduate Studies Office
If you need to take a medical leave from the Institute, you must petition through the Graduate Studies Office. Please thoroughly read through the Graduate Studies Office’s leave policy, and complete requested forms in a timely manner.
Student Wellness Services
To complete your petition to take leave, you will need the recommendation of the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Please complete all the steps below in order after connecting with the Graduate Studies Office.
Step 1: Release of Information and Records Consent Form
Complete the Release of Information and Records Consent Form for Student Wellness Services to coordinate with the Deans' Office. Please send us a secure message with the attachment via the Student Health Portal.
Step 2: Schedule an Appointment
Contact us at (626) 395-8331 and request an appointment with the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Same-day appointments are unavailable and appointment slots are limited, so please plan ahead and send completed form promptly.
Returning from Medical Leave
Graduate Studies Office
If you are planning on returning from medical leave, you should be submitting your petition to the Graduate Studies Office 6 weeks before the day which you intend to return. Please thoroughly read through the Graduate Studies Office’s leave policy, and complete the requested forms in a timely manner.
Student Wellness Services
To complete your petition to return from leave, you will need the recommendation of the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Please complete all the steps below in order, 6 weeks prior to your return.
Step 1: Release of Information and Records Consent Form
If you don't have an active Release of Information and Records Consent Form for (1) the deans' office or (2) each provider you were under the care of, please send us a secure message with the attachment via the Student Health Portal.
Step 2: Provider Report Form
Request that each of your providers mails or faxes the completed Provider Report Form to our office. Our mailing address and fax number are provided on the top of the form. These forms should be dated around 6 weeks prior to your start date.
Step 3: Schedule an Appointment
After all forms have been submitted to our office, contact us at (626) 395-8331. Request an appointment with the Clinical Director of Counseling Services (for leaves related to mental health) or the Medical Director of Health Services (for leaves primarily related to physical health). Same-day appointments are unavailable and appointment slots are limited, so please plan ahead and send completed forms promptly.