Medical Separation Sample Provider Letters
Medical Separation Sample Provider Letters
When the student initiates a Medical Separation from the university, requests to return will initially be reviewed by Student Assistance in the Dean of Students Office to clear the Medical Hold. In addition to a description of what medical conditions prompted the separation and what treatment(s) occurred while away from Iowa State, students will need to provide documentation from a licensed medical provider indicating the following.
The student is ready to resume the rigors and stress associated with the higher education environment;
The student possesses the fitness and capacity to succeed in the anticipated degree program;
Explanation of accommodations, conditions, or continuity of care plans (if any) that are recommended upon return to the campus environment.
Sample lettters that can provide guidance for students and providers are listed below:
SAMPLE 1 (on official letterhead)
Date
Name of student
Re: Medical Separation Reentry Letter of Support
Dear Iowa State University Student Assistance Staff,
STUDENT NAME indicated they withdrew due to medical reasons in Spring 2017 and I began working with them in May 2017 on a regular basis as they navigated their diagnosis and treatment of XXXXXXX medical condition. We met bi-weekly through the summer and have discussed what a return to Iowa State University would look like given their diagnosis. I can share the following:
STUDENT is ready to resume the rigors and stress associated with attending Iowa State University. They were not aware of their diagnosis during Spring of 2017 when they withdrew and have been able to understand their diagnosis and appropriate ways to cope. They also shared they have attended two summer courses at the local community college and have been able to have success in those classes.
STUDENT understands the requirements of their program and shared they understand during the more stressful periods associated with their program they need to monitor their sleep schedule and remain medication compliant.
STUDENT has 3-4 follow up physical therapy appointments they will need to attend and they will likely do those in Ames. They’ve not reported any other concerns about their mobility or other needs at this time.
Thank you.
(INSERT PROVIDERS name and credentials)
SAMPLE 2 (on official letterhead)
Date
Name of student
Re: Medical Separation Reentry Letter of Support
Dear Iowa State University Student Assistance Staff,
STUDENT NAME indicated they withdrew in Spring 2017 after they suffered a severe leg injury. I have met with them as they navigated the recovery process. I can share the following:
STUDENT is ready to resume the rigors and stress associated with attending Iowa State University. Their leg has fully healed and they only have routine follow up appointments in the coming months.
STUDENT understands the requirements of their program and there shouldn’t be any reason this injury/recovery would impact their ability to remain in that program. The only shared concern is an attendance policy and how their physical therapy may impact attendance.
STUDENT has agreed to check in with my office when they are home for breaks for medication management. We also found a provider in Ames (INSERT THEIR NAME) that will begin seeing STUDENT as they return. STUDENT would likely benefit from additional time on their exams and taking exams in a private setting. They have also discussed their desire to have an emotional support animal. My office has releases in place with Student Disability Resources to begin sharing additional documentation as needed.
Thank you.
(INSERT PROVIDERS name and credentials)