Forms

These forms may be downloaded and printed.

Note, you will need to have Adobe Acrobat Reader installed on your computer to access these forms.

Our fax number is: 970-351-3234

Our office is located in:
Cassidy Hall
1901 10th Avenue
(SW corner of 10th Ave. & 19th St.)

NOTE: The Fall Semester 2014 waiver is available online through your URSA account after May 11, 2014. The waiver deadline for Fall Semester 2014 is September 8, 2014 at 8:00pm.

Instructions for Accessing the Online Waiver Form:

  1. If you already have an URSA account, you may log into http://ursa.unco.edu, click on the Financial tab and locate the link to the "UNC Student Health Insurance Plan Online Waiver System" (SHIP). Scroll down to the "Begin" button.
  2. IMPORTANT: Please be sure to have your insurance card available before you enter the online waiver system!

  3. If you have been admitted, but do not have an URSA account, access the URSA home page at http://ursa.unco.edu and create your student account from the link titled "NEW STUDENTS START HERE." Once your account has been established, follow the same steps as in item 1 above.

2013-2014 Plan Year Documents

2012-2013 Plan Year Documents

2011-2012 Plan Year Documents

2010-2011 Plan Year Documents

NOTE: Please contact Cece Clark in the Student Health Insurance Office at 970-351-1915 for information on premium and dates of coverage.