Premier Plan Forms:
How To Obtain a 1095B Tax Form
UHCSR Claim Form
Prescription Claim Form
HPV Vaccine Medical Claim Form
Prescription Extension Request Form
To obtain prescriptions beyond the authorized 30 days when traveling outside of the United States.
Study Abroad Plan Forms:
CISI Claim Form
CMI/ACE American Co. Claim Form
CMI/ACE American Co. Claim Form Instructions
Study Abroad Waiver Form
Students enrolled in Office of International Programs' Courses, Main Campus, are required to purchase the Study Abroad Plan, without the waiver option.