Davis SHIP Downloadable Forms

Some of the files on this site are provided in portable document format (pdf). A program that can read and/or print pdf files, like Adobe Acrobat Reader, may be required.

Waivers

  • Online Davis SHIP Waiver Application - Students who have existing insurance coverage may apply for a waiver application online. The online interface will give an instant approval/denial at the time of submission; your account will be credited at a later date if appropriate.
  • Paper Davis SHIP Waiver Application - Only for students who are unable to use the online waiver application or require multiple forms of insurance to qualify.
  • Appeal of Davis SHIP Waiver Denial - Students may appeal a waiver denial within 15 business days of receiving their notice of denial.
  • Request to Cancel Davis SHIP Waiver (pdf) - Students may cancel an approved waiver application and enroll in SHIP.
  • Davis SHIP Cancellation and Refund Request - Students who have been dismissed, cancelled their registration, or who have withdrawn may request a refund of their Davis SHIP fee. Refunds will only be granted if plan benefits have not been utilized during that term and the request is submitted prior to the end of the term in which their registration status changed.

Benefits Checklist

Below are listed the Davis SHIP Benefits checklists for services rendered at the Student Health and Wellness Center as well as for outside providers. They give a brief overview of your benefits. Students are provided with a copy of these checklists when they are issued a referral.