Mercy College of Ohio
Temporary Leave/Full Withdrawal
Name and ID
First Name
Last Name
Student ID (Empower) Number
Contact Information
Email Address
Personal Email Address
Should this be different than what is listed in Empower, this email will be updated in your student profile.
Request Details
Program of Study
Please select...
Associate of Applied Science in Nursing
Associate of Applied Science in Radiologic Technology
Associate of Applied Science in Surgical Technology
Associate of Science in Health Sciences
Associate of Science in Health Information Technology
Bachelor of Science in Biology
Bachelor of Science in Healthcare Administration
Bachelor of Science in Medical Imaging
Bachelor of Science in Medical Laboratory Science
Bachelor of Science in Nursing
Master of Health Administration
Master of Science in Nursing
Certificate in Community Health Worker
Certificate in Computed Tomography
Certificate in EMT - Basic
Certificate in Imaging Quality and Safety
Certificate in Medical Coding
Certificate in Medical Resonance Imaging
Certificate in Paramedic
Certificate in Phlebotomy
Certificate in Polysomnographic Technology
Certificate in Mamography and Bone Densitometry
Graduate Certificate
Program of Study not listed
Semester
Please select...
Fall
Spring
Summer
Year
Do you plan on completing your current courses?
Yes
No
Do you plan to return to Mercy College?
Temporary Leave - Plan to return
Full College Withdrawal - Not returning
When do you plan to return to Mercy College?
Next Semester
Other Term
Don't Know
Term
Please select...
Fall
Spring
Summer
Year
Once submitted, this will be reviewed by the Office Student Records. If you have any questions or need assistance, please contact the Office of Student Records at 419-251-8900, or via email at registrar@mercycollege.edu. Thank you.
Reason(s) for Temporary Leave or Full Withdrawal from Mercy College
Transferring to another higher education institution
Personal or family health issues requiring time off for recovery or caregiving
Financial difficulties making it challenging to afford tuition or living expenses
Difficulty adjusting to college life or feeling overwhelmed by academic workload
Mental health concerns such as anxiety, depression, or stress impacting academic performance
Job opportunities or career changes requiring immediate attention or relocation
Family responsibilities such as childcare, eldercare, or supporting family members financially
Academic struggles or dissatisfaction with the chosen major or program
Conflict with professors, classmates, or college administration affecting the learning environment
Housing issues such as unsafe or unsuitable living conditions
Military service or deployment obligations
Desire to pursue alternative educational opportunities or vocational training
Lack of motivation or interest in continuing with higher education at the present time
Dissatisfaction with the college environment, culture, or campus resources
Personal crisis or traumatic event necessitating a break from academic studies
Undecided about future career goals or academic interests, leading to uncertainty about college enrollment
Other
Please select all the reasons that apply from the list above.
If transferring, please share where you will be attending
If "Other", please explain
Would you like someone to reach out to you about your experience?
Yes
No
Mercy College of Ohio, a Catholic institution with a focus on healthcare, educates and inspires students to lead and serve in the global community.