The ISU Department of Athletics requires verification of primary personal health insurance 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal details, including your name, cell phone number, Bengal ID#, date of birth, and sport. Ensure all information is accurate.
3. Complete the PRIMARY HEALTH INSURANCE INFORMATION section. Fill in the policy holder’s name, their date of birth, relationship to you, and contact details. Attach a copy of both sides of your health insurance card.
4. Indicate whether your insurance requires a second opinion or pre-authorization for surgery by checking the appropriate boxes.
5. If applicable, provide details about any secondary insurance coverage and attach its card as well.
6. Review the TERMS section carefully. Confirm that all information is accurate and complete before signing.
7. Finally, submit the completed form along with copies of your insurance cards via mail or email as specified at the bottom of the document.

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