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:
1901 10th Avenue
(SW corner of 10th Ave. & 19th St.)
NOTE: The online waiver for Fall 2016 - 2017 is available through URSA. The deadline to waive the UNC insurance for Fall 2016-2017 is September 2 at 5:00 pm mst.
Instructions for Accessing the Online Waiver Form:
- 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.
- 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.
IMPORTANT: Please be sure to have your insurance card available before you enter the online waiver system!
2015-2016 Plan Year Documents
- Health Insurance Booklet - 2015-2016
- Re-Enrollment Form - 2015-2016
- Dependent Enrollment Form - 2015-2016
- Sports Rider Enrollment Form - 2015-2016
NOTE: Please contact Cece Clark in the Student Health Insurance Office at 970-351-1915 for information on premium and dates of coverage.