Downloadable Forms

In order to make use of the downloadable forms and brochures, you'll need the free Adobe Acrobat Reader.


Pre-Registration Booklet & Forms:

   2009 - 2010 Pre-Registration Booklet & Forms

Medical Forms:

   CUMC SHS Medical Release Form
   CUMC SHS Medical Record Request Price List
   Meningococcal Meningitis Response Form

Pre-Registration and Medical forms should be sent to Elsa Cadena via one of the following methods:

Fax: 212-305-2176 or 212-342-3955
Mail: 630 West 168th Street, P&S Box 77, NYC 10032
In Person: 60 Haven Avenue, Floor Lobby

Enrollment Forms:

   Dependent Enrollment Application
   8/17/09 to 8/16/10 Post-Doctorate Fellow Enrollment Application
   Part-time and Approved Leave Enrollment Application
   Verification of Approved Leave Application

Other Forms:

   Petition for Waiver of Spring Health Fee(s) – February Degree Candidates
   Petition to Enroll or Drop After Deadline/Life Change Event Form
   2009-2010 SHS Waiver for >50 Miles
   Dual Degree Students

Enrollment and Other Forms should be sent to Eladia Goris via one of the following methods:

Fax: 212-342-3947
Mail: 630 West 168th Street, P&S Box 77, NYC 10032
In Person: 60 Haven Avenue #3E


Brochures

2009-2010 Aetna Student Health Insurance Plan Brochure
2009-2010 SHS and Student Health Insurance - A Brief Guide
2009-2010 SHS Overview Brochure
2009-2010 Mental Health Services Brochure
Columbia Dental Associates Student Dental Plan
Aetna Advantage Dental Plan Overview
Getting What You Want from Alcohol and Other Substances
About Acupuncture