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Student Life

Health & Counseling Center

Insurance and Health Forms

Student health insurance plan (SHIP)

Brochure:

2017-18 Coverage Summary (PDF)

2017-18 Coverage Brochure (PDF)


Enrollment:

Student Health Insurance Enrollment 2017-18 (PDF)

Loss of Coverage SHIP 2017-18 (PDF)

Continuous Enrollment SHIP 2017-18 (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) 

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.