Required for New Students
- Immunization Verification Form - Due June 1, 2014
-May submit by e-mail in .pdf format to email@example.com. Afterwards, you will receive a confirmation e-mail with further instruction, if necessary.
Insurance and Other Forms (Waiver and Enrollment forms may be found under the insurance tab)
- Medical Record Release Form: To release or obtain a copy of your immunization records and/or any medical records, please complete this form and mail or fax it to us. We will mail or fax your records within 3-5 business days of receiving the completed form and payment.
- Insurance Enrollment or Waiver Form: All students who want to enroll or waive the student insurance plan need to fill out this form. This link will also allow you to enroll dependants.
- Fall Only Health Insurance Form: All students who are graduating or leaving the university and would no longer like the Student Health Insurance coverage for the Spring semester.
- Prescription Drug Claim Form: Students needing to submit a claim for a prescription to the Insurance Company should fill out this form and mail it along with the pharmacy receipt to the address on the form.