Staff:
Debbie
Quinn
Director
Cynthia
Linton
Student Health
Administrator
Lucia Fenney
Student Health Assistant
Gianna
Dimitrakos
Immunization Data Coordinator
John V.
Pruitt, MD
Consulting Psychiatrist
Forms
Immunizations:
For all students:
By School:
- School of Dental Medicine Immunization Form
- School of Medicine Immunization Form
- Public Health & Professional Degree Programs' Immunization Form
- Friedman School of Nutrition Science and Policy Immunization Form
- Sackler Graduate School of Biomedical Sciences' Immunization Form
- Cummings School of Veterinary Medicine Immunization Form
Health Insurance:
The Student Group Coverage with Tufts Health Plan, HMO
- Tufts Health Plan (THP) Member Enrollment Form (the Application)
- Tufts Health Plan (THP) Member Enrollment Form Instructions
- Payroll Deduction Form for Sackler Graduate School of Biomedical Sciences' Students
Graduating & Cancelling Tufts Health Plan Insurance
Tufts Health Plan Cancellation Policy & Form, Fall 2009 for students in the School of Dental Medicine, the School of Medicine, the Friedman School of Nutrition Science and Policy, the Cummings School of Veterinary Medicine, and the Public Health & Professional Degree Programs.
Tufts Health Plan Cancellation Form for students in the Sackler School of Biomedical Sciences.
Leaving the University & Cancelling Tufts Health Plan Insurance
- Leave of Absence - Keeping THP Health Insurance Agreement Form
- Leave of Absence - Cancelling THP Insurance Form
- Withdrawal/Dismissal - Cancelling THP Insurance Form
Health Insurance Waiver Forms:
Academic Year 2009-2010 - (09/01/2009 through 08/31/2010)
Insurance Waiver Form for students in the School of Dental Medicine, the School of Medicine, the Friedman School of Nutrition Science and Policy, the Cummings School of Veterinary Medicine, and the Public Health & Professional Degree Programs.
Insurance Waiver Form for students in the Sackler Graduate School of Biomedical Sciences.
October 2009
Tufts University, Student Advisory &
Health Administration
200 Harrison Avenue, Boston, MA 02111
Phone: 617-636-2700, FAX: 617-636-2708
Copyright © 2001, Tufts University