SHS Forms
If you are using a public computer to fill out any SHS form, DO NOT save the form after completion because your personal information will be saved on that particular computer for everyone to see. After completing the form print and close the application so that all information will be deleted.
| Blue Shield Claim Form The revised Blue Cross student claim form for the campus-sponsored student health insurance policy |
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| Health Insurance Enrollment card 07-08 - Please complete ONLY if you want to purchase your insurance and pay by *Money Order or Cashier’s Check.* For online purchase go to https://www.csuhealthlink.com/ssi/default.aspx. | |
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| Affidavit of Insurance forms for F-1 visa students - Explains how to Document Your International Health Insurance Coverage. |  |
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| Affidavit of Insurance forms for J-1 visa students - Explains how to Document Your International Health Insurance Coverage. | |
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| Family Pact Covered Services Form | |
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| Family Pact Eligibility Screening Form | |
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| Family Pact Client Eligibility Certification (CEC) | |
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| Extra Credit Attendance Form | |
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| Extra Credit Evaluation Form | |
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| Health History Form - For ALL students | |
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| Health History Form - FOR ATHLETES | |
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| Health History Form - For ASI Early Childhood Education Center. | |
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| MMR Form | |
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| Petition for Waiver of No-Show Fee (fill-able) | |
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| Peer Educators Advocating Campus Health (PEACH) Program Description | |
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| Peer Educators Advocating Campus Health (PEACH) application | |
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| Student Health Advisory Committee (SHAC) application | |
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| Plan B or Morning After Pill consent form | |
