Get the free 20132014 Student Dental Enrollment Form - shsu

Blue Cross and Blue Shield of Texas 10405013 SAM HOUSTON STATE UNIVERSITY 20132014 Student Dental Enrollment Form Please complete the form below or enroll online at www.ahpcare.com/shsu. Dental coverage

How to fill out 20132014 student dental enrollment

How to fill out the 2013-2014 student dental enrollment form:

1. Begin by carefully reading through the entire form to understand the information requested and the instructions provided.
2. Gather all the necessary documentation and information needed to complete the form, such as the student's personal details, insurance information, and dental history.
3. Start by filling out the student's personal information section, including their name, address, date of birth, and contact information.
4. Provide the student's insurance information, including the name of the insurance company, policy number, and any additional coverage details.
5. Answer the questions regarding the student's dental history, including previous dental procedures, treatments, and any ongoing oral health issues.
6. If necessary, provide any other required information, such as emergency contact details or additional insurance information.
7. Carefully review the completed form to ensure all information is accurate and complete.
8. Sign and date the form as required, indicating your consent and agreement with the provided information.
9. Submit the form according to the instructions provided, whether it's by mail, fax, or electronically.

Who needs the 2013-2014 student dental enrollment:

1. Students who are enrolled in an educational institution during the 2013-2014 academic year and are eligible for dental coverage through their school.
2. Parents or legal guardians of students who are under the age of 18 and require their consent and input for the enrollment process.
3. Dental insurance providers or administrators who require accurate and up-to-date information for the enrollment and coverage process.

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What is 20132014 student dental enrollment?

20132014 student dental enrollment is the registration process for students to obtain dental coverage.

Who is required to file 20132014 student dental enrollment?

All students enrolled in the specified academic year are required to file 20132014 student dental enrollment.

How to fill out 20132014 student dental enrollment?

To fill out 20132014 student dental enrollment, students need to provide their personal information, contact details, and dental insurance preferences.

What is the purpose of 20132014 student dental enrollment?

The purpose of 20132014 student dental enrollment is to ensure that students have access to dental coverage during the academic year.

What information must be reported on 20132014 student dental enrollment?

The information required on 20132014 student dental enrollment includes student's name, date of birth, contact information, insurance provider details, and coverage options.