Request for Reactivation from LOA Form Header Image


This form is to be used to request reactivation from a leave of absence that extends beyond 180 calendar days.

Please enter your Datatel student ID number found under "My Profile" in the student menu on IONLINE. NOTE: Leading Zeros are not required.

Please inlcude your email address for confirmation of receipt.
Please select your current program.
School of Nursing students must choose one of these options*
Please enter the semester in which you plan on returning and registering officially.
Today's Date*
Use your mouse or finger to draw your signature above

Please make note:

  • As stated in the MGH Institute of Health Professions Catalog: If a student desires to interrupt the defined program of study for at least one academic semester, then s/he must request a leave of absence. It is the student's responsibility to complete a "Withdrawal/Leave of Absence" form and obtain the necessary approvals. Students are allowed a maximum of one year of leave but, if a leave extends beyond 180 calendar days, the status of the leave will be changed to Leave of Absence/Withdrawal for title IV Financial Aid Purposes. Students in this category complete this form to be re-instated.
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