Health Related Forms

Blanket Student Accident and Sickness Insurance for International Students/ScholarsPDF Icon This brochure is a summary of your benefits under the plan of insurance sponsored by the school.
Blanket Student Accident and Sickness Insurance for the Dependents of International Students/ScholarsPDF Icon This brochure is a summary of your benefits under the plan of insurance sponsored by the school.
Health Center Authorization & Referral Claim Form for International StudentsPDF Icon This form is only to be used if treatment that was received in the United States.
Health Center Authorization & Referral Form for International StudentsPDF Icon Health Center Authorization & Referral Form for International Students
Medical & Security Evacuation & Repatriation ProgramPDF Icon This brochure describes Medical & Security Evacuation & Repatriation Program available for Inbound and Outbound International Students, Scholars, Researchers, Professors and their Dependents
Medical Reimbursement Form for International StudentsPDF Icon For Claims Incurred Outside of the United States
Prescription Reimbursement Form for International StudentsPDF Icon Used by international students for prescription reimbursement
NOTE: Forms were made available thru Haylor, Freyer & CoonExternal Icon
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