Forms, University of Cincinnati

University Health Services

Student Health Insurance
- Frequently Asked Questions
- Benefits and Services
- Find a Doctor, Hospital, Etc.
- ID Card - Forms
- Bloodborne Pathogen Exposure Insurance
Health Clinics
Mental Health
Athletic Medicine
Request Medical Records
Pharmacy
Emergency Needlestick/BBP Info
Work Related Injury
Immunization Requirements
New Students
Employee Disability Management Services
Environmental Health & Safety

Two Clinic Locations:

LINDNER CLINIC | PHONE (West Campus): 513-556-2564
Medical Records Fax: 513-556-1337

HOLMES CLINIC | PHONE (East Campus): 513-584-4457
Medical Records Fax: 513-584-2222

Forms

2012 – 2013 SHI Waiver and Enrollment

2012–13 UC Student Health Insurance Waiver Form for VAMC-Eligible Students Only

2012–13 UC Student Health Insurance Enrollment Form

Form - KLAIS & COMPANY, INC. CLAIM.pdf

Form- Enroll After Deadline.pdf

Form - Withdraw for Medical Reasons.pdf

Personalized 2012–13 Student Health Insurance I.D. Card: Log In

Student Health Insurance
University of Cincinnati
Richard E. Lindner Center
2751 O'Varsity Way, Suite 334
Cincinnati, OH 45221-0010
Phone: 513-556-6868; Fax 513-556-6655