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:

   2008 - 2009 ( Fall start) Clinical Students Pre-Registration Booklet & Forms
   2008 - 2009( Fall start) Non-Clinical Students Pre-Registration Booklet & Forms

Medical Forms:

   CUMC SHS Medical Release Form
   CUMC SHS Medical Record Request Price List
   Meningococcal Meningitis Response Form
   Student Influenza Vaccine Declination Form

Enrollment Forms:

   Dependent Enrollment Application
   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
   SHS Waiver for >50 Miles

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

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


Brochures

2008-2009 Aetna Student Health Insurance Plan Pamphlet
2008-2009 Aetna Student Health Insurance Plan Brochure
SHS Overview Brochure
Mental Health Services Brochure
Insurance FAQs Brochure
Columbia Dental Associates Student Dental Plan
Aetna Advantage Dental Plan Overview