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Domestic Student Insurance Forms

• 2012 – 2013 Student Health Insurance Plan Brochure (PDF)
• 2012 – 2013 Part-Time Enrollment Form for Students/Dependents Undergrad/Grad/Professional (PDF)

International Student Insurance Forms

• 2012 - 2013 International Student Enrollment Form (PDF)
• 2012 – 2013 MEDEX Enrollment Form (PDF)
• 2012 – 2013 J-1 and J-2 Waiver Form (PDF)
• 2012 – 2013 International Waiver Form (PDF)
• 2012 – 2013 SUNY Dependent Enrollment Form (PDF)

Study Abroad Insurance Forms

• 2012 – 2013 HTH Study Abroad Enrollment (PDF)
• 2012 – 2013 MEDEX Enrollment (PDF)
• Study Abroad Waiver (PDF)
• 2011 – 2012 MEDEX Policy Brochure (Not Yet Available)