GA, GRA, and, Fully Funded Fellows Discounted Student Health Insurance Program Enrollment Form
If you are interested in purchasing the Student Health Insurance at The George Washington University, please fill out this form. The open enrollment for the Spring 2020 semester will be December 1st - January 31st. Please note, the charge for the Student Health Insurance will be added to your student account bill two weeks after completion of enrollment.

If you wish to enroll in the plan, please complete this enrollment form.
Please do not enroll on the Aetna site, as this form is used for your enrollment.
If you need to enroll dependents into the plan please contact the Health Insurance Coordinator.

To contact our Health Insurance Coordinator email ship@gwu.edu or call 202-994-5300 option #5. The Student Health Insurance Program is only available for domestic students.

You can find a brochure for the program here:
https://healthcenter.gwu.edu/sites/g/files/zaxdzs1216/f/downloads/GWU%201920%20PD%26BS%20FINAL%20Formatted%20Remediated.pdf
Email address *
Next
Never submit passwords through Google Forms.
This form was created inside of The George Washington University. Report Abuse