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Campus Life & Inclusive Excellence

Health & Counseling Center

Insurance and Health Forms

Student health insurance plan (SHIP)

Brochure:

2019-20 Coverage Summary (PDF)

2019-20 Coverage Certificate Brochure (PDF)


Enrollment:

Student Health Insurance Enrollment 2019-20 (PDF)

Loss of Coverage and Study Abroad SHIP 2019-20 (PDF)

 

Set up a United HealthCare Student Resource Insured account

 

Health & Counseling Fee (HCF)

Enrollment form for the Health & Counseling Fee (PDF) for quarter and semester students.

 

HCC Release of Information Form and parental consent

Release of Information (ROI) Form (PDF) 

Campus Partners release of information form (PDF)

Parental Consent Form (PDF)

 

Immunization Form

Immunization Form (PDF)

Immunization Exemption Form (PDF)

 

study abroad Forms (Quarter Students)

Please contact the HCC at 303.871.2205 for information on Study Abroad Coverage.