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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 2020-2021

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

International Students 2020-2021

  • **Note: F1 Students are automatically enrolled and do NOT need to fill out this form. This form is utilized for enrolling J1 Faculty requesting coverage, as well as for enrolling dependents of F1 Students and J1 Faculty.**