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Forms

The following links are downloadable PDFs for students covered by personal insurance or enrolling in the Student Health Insurance Program (SHIP).

Completed forms can be returned via:

Fax: (208) 885-1002
Mail: 875 Perimeter Drive MS 4201, Moscow ID 83844-4201
Drop-off: SHIP Office, Room 129 in the Student Health Services building
There is also a drop box inside the University Avenue entrance of the Student Health Services building | Map

Submit Insurance Information

Personal insurance information must be submitted online before the first day of the semester. To submit information:

  1. Log in to VandalWeb using your NetID and password
  2. Click on “Students Menu”
  3. Click on "Student Health Insurance Menu"
  4. Click on “Health Insurance Information Form”
  5. Select term from the drop-down list
  6. Complete form
  7. Submit

Printable Health Insurance Information Form

Students who register for classes after the semester begins or who did not submit a Health Insurance Information Form online before the first day of classes (late fees will apply) may print and submit a Health Insurance Information Form.

Download 2016-2017 Health Insurance Information Form (PDF) »

Fax completed forms to (208) 885-1002 or place in the SHIP drop box inside the University Avenue entrance of the Student Health Services building. View map »

Update Insurance Information

Students who submitted a Health Insurance Information Form and have a change in policy may update information online after the semester begins. To submit information:

  1. Log in to VandalWeb using your NetID and password
  2. Click on “Students Menu”
  3. Click on "Student Health Insurance Menu"
  4. Click on “Update Health Insurance Information Form”
  5. Select term from the drop-down list (only available after semester begins)
  6. Complete form
  7. Submit

SHIP Forms

2016-17 SHIP Qualified Late Enrollee Form (PDF) »
2015-16 SHIP Qualified Late Enrollee Form (PDF) »
For students who have involuntarily lost employer-sponsored health insurance or Medicaid. Documentation showing details of the qualifying event must be attached to the completed form and submitted within 30 days of loss of coverage.

SHIP Special Circumstance Enrollment Form (PDF) »
For students who do not meet the standard eligibility provisions for SHIP enrollment. Form must be completed by the first day of each semester.

Contact Us

Idaho Commons Room 406

Mailing Address:
875 Perimeter Drive MS 4201
Moscow, ID 83844

Phone: (208) 885-2210

Fax: (208) 885-1002

Email: health@uidaho.edu

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