Submit the completed form, along with the Release of Information form, to the BU Health and Counseling online portal. Login at: https://binghamton.medicatconnect.com/. Sign in using your University username and password. Go to the UPLOADS section of the portal and use the option 'Withdrawal/Re-enrollment Forms.' Ensure forms are uploaded using the correct option to avoid delays in the review process. For questions, contact Decker Student Health Services at 607-777-2221 or the University Counseling Center at 607-777-2772. Always double-check the uploaded documents for completeness and accuracy to ensure a timely re-enrollment process.

Ensure to submit the re-enrollment form before the start of the desired return semester. Key dates for 2024: Spring (January), Summer (May), Fall (August), Winter (December). Key dates for 2025: Spring (January), Summer (May), Fall (August), Winter (December).

The purpose of the Binghamton University Re-enrollment Form is to facilitate the return of students who withdrew from the university due to medical or psychological reasons. The form must be completed by the student’s treating provider to confirm that the student is fit to return and continue their studies. The information provided helps university administrators to assess the student’s readiness and to put in place necessary support and accommodations for a successful transition back to academic life. Completing this form is a crucial step in ensuring that the student receives proper guidance and resources upon their return. The treating provider's detailed assessment provides insights into the student's progress and current condition, which is essential for creating a supportive environment tailored to the student's needs. By understanding the circumstances of the withdrawal and the improvements made during the time away, the university can better address any ongoing challenges the student may face. Ultimately, this form serves to protect the student’s well-being and academic success. It is part of the university’s commitment to creating a safe and supportive campus environment. The thorough review process ensures that all returning students are ready to handle the demands of their courses while benefiting from adequate health and counseling services.

• 1. Student Information: Contains fields for student name, university B#, date of birth, status, and contact information.
• 2. Provider Information: Includes fields for the provider's name, credentials, license number, business address, phone and fax numbers.
• 3. Withdrawal Information: Details the withdrawal semester, diagnosis, circumstances leading to withdrawal, and desired return semester.
• 4. Treatment and Re-enrollment Information: Requires appointment details, current diagnosis, evidence of functional improvement, and concerns regarding the patient's safety and ability to function as a student.
• 5. Recommendation for Services: Lists offices that may provide support and services beneficial for the returning student.
• 6. Treatment Recommendations: Outlines appointment type, frequency, medication needs, and living arrangements, with inquiries about the continuation of care.
• 7. Submission Instructions: Includes details on how and where to upload the completed form with the Release of Information form.

If you fail to submit this form, your re-enrollment process could be delayed or denied. The form is critical for ensuring that the student is ready and able to return to coursework.

• Enrollment Delay: Failure to submit the form can result in delays in your re-enrollment process.
• Enrollment Denial: Incomplete submissions or missing required release of information can lead to denial of re-enrollment.
• Lack of Support: Without this form, the university cannot adequately provide necessary support and accommodations.

• 1. Medical Withdrawal: When returning after a withdrawal due to a medical condition.
• 2. Psychological Withdrawal: When returning after a withdrawal due to a psychological condition.
• 3. Support Assessment: To determine the level of support and services needed for a successful return.
• 4. Provider Recommendation: When a treating provider needs to officially recommend re-enrollment.
• 5. University Coordination: To help university administrators coordinate the student's return and support.