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Insurance Forms

Provided here are insurance forms, past and present. As always, if you have any questions or need help, do not hesitate to contact us

Domestic Students 202-2023

Berkley Accident and Health Insurance (Accident Only Policy)
- You must complete this form when making a Berkley Accident & Health Claim.

International Students 2022-2023

Wellfleet Insurance (Sickness and Accident Policy)
- Plan Waiver Form: https://www.studentinsurance.com/SI/no_enrl.asp?otherCoverageOnline=0&renewOnline=False&iCollegeID=934
**Note: F1 Students are automatically enrolled and do NOT need to fill out this form.**

Appointment Tips

Call us

Make an appointment by calling (337) 482-1293.

We are open during semester breaks and University administrative office hours. Please refer to our Clinic Hours for any additional information.

Learn more about services and costs.

First Appointment

Have your photo ID ready when checking in. Bring a copy of your insurance card to every visit. Also, please bring your current medications (bottles) to your first visit.

Learn more about services and costs.

Subsequent visits

Don't forget your photo ID and insurance card at every visit.

Medical Insurance

If you have medical insurance, please bring a copy of your insurance card to your visit.

If you do not have a medical insurance plan, we will work with you to help you with any bills you may receive for services provided at Student Health Services.

Refer to our Student Insurance page for more information about recent changes in federal law regarding medical insurance.

Learn more about services and costs.

Parking For Visits

Parking on UL campus is strictly enforced. To avoid being ticketed, please park in your assigned parking zone and allow sufficient time to walk to the Wellness Center for your appointment. If you're unable to walk, there is limited designated parking in front of our building on Hebrard Blvd. You must come in and get an parking pass from the front desk. Please park only in our designated parking spaces. For those who don't have parking permits, you may pay to park at Girard Park Circle Parking Tower.

Proof of Immunization Compliance

All students applying for admissions to the University must complete the Immunization Compliance Form.

Students can also request an exemption from the required immunizations.

You may be able to print a copy of your immunization record after registering your information at la.myir.net.

If you have any concerns or questions, please call (337) 482-1178 or see our Frequently Asked Questions for Immunization Compliance .

University of Louisiana at Lafayette

Office of Student Health Services

Student Affairs Division

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