Please use our secure file drop to submit your VHW or return request forms. The required forms can be found below. 

51ԹϺ students may apply for a Voluntary Health Withdrawal (VHW), a separation of the student from the university, if they experience medical or psychological conditions that significantly impair their ability to function successfully and safely in their role as a student.

A student must be enrolled in the current semester to be eligible for a VHW and a VHW can only be applied to the current semester (before grades are posted).

If a VHW is approved, all classes for the semester are removed from the student’s transcript.  The student cannot select 1 or 2 courses – a VHW applies to all courses for the semester.

  • After a grade is posted for a course, a VHW cannot override a posted grade.  Once a grade is posted, an undergraduate student would need to petition Faculty Senate (see instructions and link at the bottom of this web page).  A graduate student would need to submit an appeal form via their Grad Rebel Gateway.
  • A VHW cannot be retroactively applied to a previous semester.

The VHW policy does not extend to family members who are ill.

  • If a student experiences hardship due to caring for an ailing family member, the student would not request a VHW.  Instead, an undergraduate student would need to petition Faculty Senate (see instructions and link at the bottom of this web page).  A graduate student would need to submit an appeal form via their Grad Rebel Gateway.

Download and work with your Health Care Provider to complete the forms, found in the pdf link below.

Procedure to Request a Voluntary Health Withdrawal (VHW)

The Forms Required to Process a VHW Are:

Student Checklist for Requesting a Health Withdrawal

(to be signed and dated by the student)

Request for a Voluntary Health Withdrawal

(to be completed by the student)

Health Care Provider Evaluation Summary for Health Withdrawal

(to be completed by the health care provider(s))

Authorization for Release of Protected Health Information

(to be completed by the student with health care provider’s information)

All four (4) forms are required by the Health Withdrawal Committee. A student may submit additional supporting documentation, but additional documentation does not replace the forms listed above. 

Voluntary Health Withdrawal Form

Submit Completed Forms

Online Submission

Via Fax

702-895-4316

In Person

Student Wellness Center (SWC) Front Desk on the 1st floor in the Student Recreation & Wellness Center (SRWC) across from the restrooms and water fountains

By Mail

University of Nevada, Las Vegas
c/o Voluntary Health Withdrawal
Box 452005
4505 S. Maryland Parkway
Las Vegas, NV 89154-2005

Review of request and subsequent processing, if approved, may take 14-29 university working days.

If a request for a VHW is approved:

  • The Health Withdrawal Committee will work with the Office of the Registrar and Student Accounts to place the student in “Leave of Absence”(LOA) status.
  • No protected health information will be shared with other campus units; only information about the approval of leave of absence, on an as-needed basis.
  • All traces of the classes registered for in that semester are removed; nothing will show on the transcript for that term.
  • A tuition refund for credit hours is processed, if applicable.  Note - special fees cannot be refunded.
    • If the student received financial aid or a scholarship, the student must contact the Financial Aid Office at 702-895-3424. Requesting and receiving a VHW does not absolve the student from Financial Aid policies and responsibilities and Financial Aid funds used to pay tuition and fees is unlikely to be “refunded” to the student.

Procedure to Request a Return from a Voluntary Health Withdrawal (VHW)

If a VHW is approved, the student is placed in “Leave of Absence” (LOA) status, must complete “Request to Return” paperwork, and be approved to return to register for future courses.

The forms required to return from a VHW are:

Request to Return from a Voluntary Health Withdrawal

(to be completed by the student)

51ԹϺ Medical/Mental Health Clearance

(to be completed by the health care provider(s))

Authorization for Release of Protected Health Information form

(to be completed by the  student with health care provider’s information

Request to Return from a VHW forms are sent to the student with their VHW approval letter after the initial process has been completed.

Request to Return from Voluntary Health Withdrawal Form

Petitions and Appeals

Faculty Senate General Petition Form

Faculty Senate Website

  • Scroll down to Student Resources
  • Click on Withdrawal under Student Petitions for a General Petition Form

Complete Steps 1 through 4 of the form and according to Step 5 - Drop off completed petition to the appropriate academic advising center of your major or Department for signatures.  The petition will be submitted to the Faculty Senate office by the academic advising center and you will be notified of the decision.

Graduate College Appeal

  • Click Forms, Other Forms, Appeal Form
  • The form will route electronically for review

Tuition & Fee Appeal Form

Fee Appeals

  • Click on Fee Appeal Form

Complete the form and submit to Cashiering & Student Accounts office.

Related Links

Voluntary Health Withdrawal Assistance

If a student requires assistance with the voluntary health withdrawal policies and procedures, the student can contact vhw@unlv.edu or call 702-895-0136.