Get the free MSU Care Enrollment - Missouri State University
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Page 1PATIENT REGISTRATION FORM
Today's Date:
PATIENT INFORMATION
Patients last name:
D.O.B:First:
Age:Middle Initial:SSN:
(last 4 digits) :
SSN (required):Sex:Marital Status:Address:
City:State:Home
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How to fill out msu care enrollment
How to fill out msu care enrollment
01
Obtain the MSU Care enrollment form from the MSU Health Center or download it from their website.
02
Fill out all the required personal information such as name, address, date of birth, and contact information.
03
Indicate your insurance information if applicable.
04
Provide information about your medical history and any current medical conditions.
05
Sign and date the form to attest to the accuracy of the information provided.
06
Submit the completed form to the MSU Health Center either in person or through their online portal.
Who needs msu care enrollment?
01
Students of Michigan State University who wish to access medical services at the MSU Health Center.
02
Faculty and staff of Michigan State University who want to enroll in the MSU Care program for their healthcare needs.
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What is msu care enrollment?
MSU Care Enrollment is a process by which students can sign up for health insurance coverage through Michigan State University.
Who is required to file msu care enrollment?
All students who are enrolled at Michigan State University are required to file for MSU Care Enrollment unless they already have proof of comparable health insurance coverage.
How to fill out msu care enrollment?
Students can fill out MSU Care Enrollment online through the university's student portal or by contacting the health insurance office for assistance.
What is the purpose of msu care enrollment?
The purpose of MSU Care Enrollment is to ensure that all students have access to adequate health insurance coverage while attending Michigan State University.
What information must be reported on msu care enrollment?
Students must report their personal information, proof of health insurance coverage or sign up for MSU Care Enrollment, and any relevant medical history.
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