Forms
These forms may be downloaded and printed on
your printer for completion.
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 2009 Waiver is available online through your URSA account.
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).
IMPORTANT: Please be sure to have your insurance card available before you enter the online waiver system!
2. 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.
THE DEADLINE TO WAIVE PARTICIPATION IN THE UNC-SPONSORED PLAN FOR FALL SEMESTER 2009 IS SEPTEMBER 4.
2009-2010 Plan Year Documents
Health Insurance Booklet - 2009-2010
Plan Highlights Flyer - 2009-2010
Dependent Enrollment Form - 2009-2010
Re-enrollment Form - 2009-2010
Sports Rider Enrollment Form - 2009-2010
Temporary ID Card - 2009-20102008-2009 Plan Year Documents
Health Insurance Booklet - 2008-2009
Dependent Enrollment Form - 2008-2009
Re-enrollment Form - 2008-2009
Sports Rider Enrollment Form - 2008-2009
NOTE: Please contact the Student Health Insurance Office at 970-351-1915 for information on premium and dates of coverage.
