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UC Davis Student Health Insurance Plan (UC SHIP) Waiver Application 20162017 INSTRUCTIONS 1. Complete all applicable sections. a. Incomplete waiver applications will NOT be processed. 2. Make a copy
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How to fill out UC Davis Health Center:

01
Obtain necessary forms: Start by obtaining the required forms from the UC Davis Health Center. These forms may include personal information, medical history, insurance details, and any other relevant documentation.
02
Complete personal information: Begin by filling out your personal details accurately. This may include your name, address, contact information, date of birth, and social security number.
03
Provide medical history: Fill out the medical history section, providing information about any pre-existing medical conditions, allergies, medications, and previous medical treatments or surgeries. Be thorough and ensure accuracy to assist healthcare providers in providing appropriate care.
04
Include insurance information: If you have insurance coverage, fill out the insurance information section. Provide details about your insurance provider, policy number, and any necessary contact details. This will help facilitate the billing process and ensure seamless healthcare services.
05
Sign consent forms: Review and sign any consent forms required by the UC Davis Health Center, such as those related to treatment, privacy policies, and release of medical information.
06
Submit the forms: Once you have completed all necessary sections, submit the forms to the UC Davis Health Center. It is advisable to make copies of the completed forms for your records.
07
Wait for confirmation: After submitting the forms, wait for a confirmation or acknowledgement from the UC Davis Health Center. This may include an appointment confirmation, a receipt of your forms, or any other relevant communication.

Who needs UC Davis Health Center?

01
Students: UC Davis Health Center primarily caters to the healthcare needs of UC Davis students. Whether you are an undergraduate, graduate, or professional student, the health center can provide you with medical services, preventive care, mental health support, and access to various specialists.
02
Faculty and Staff: UC Davis Health Center also serves faculty and staff members associated with UC Davis. They can avail themselves of primary care services, consultations, immunizations, and other necessary medical facilities.
03
Dependents: Dependents of UC Davis students, faculty, or staff members may also be eligible to receive healthcare services at the UC Davis Health Center. These dependents may include spouses, domestic partners, and children.
It is important to note that eligibility may vary based on individual situations, insurance coverage, and specific policies of UC Davis Health Center. It is recommended to reach out to the health center directly for more information on eligibility and available services.
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The UC Davis Health Center is a medical facility affiliated with the University of California, Davis.
All students, staff, and faculty at UC Davis are required to utilize the services of the UC Davis Health Center.
To utilize the services of the UC Davis Health Center, individuals must schedule an appointment with a healthcare provider.
The purpose of the UC Davis Health Center is to provide healthcare services and resources to the UC Davis community.
Information such as medical history, insurance information, and any current health concerns must be reported when utilizing the services of the UC Davis Health Center.
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