Download the following forms in PDF format.
- Guest Membership Application: Available for members who will be out of the area for a minimum of 90 days, including long-term travelers, families apart, and students
- Application to Continue Coverage for a Disabled Dependent Child
- Medical Claim Form
- Influenza Vaccination Reimbursement Form
- HIPAA Authorization Form
Dependents may be eligible for coverage until they reach age 26. Contact your benefits representative for information on how to enroll your student dependent.