Davis SHIP Forms

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 UC 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 UC SHIP Waiver Application - If you are unable to complete an online waiver application, you may submit a paper application.
  • Appeal of UC 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 Davis 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SHIP Cancellation and Refund Request - Students who have been dismissed, cancelled their registration, or who have withdrawn may request a refund of their Davis SHIP fee.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.