Eiia form 2026

1. Click ‘Get Form’ to open the eiia form in the editor.
2. Begin with SECTION 1: STUDENT STATEMENT. Fill in your School Name, Policy/Coverage Number, and your Last Name, First Name. Ensure you provide your Student ID# and complete your address for correspondence.
3. Continue by entering your Phone Number, Email Address, and Date of Birth. Indicate whether this claim is for an Accident or Sickness and provide details about the incident.
4. In SECTION 2: INSURANCE STATEMENT, confirm if you are insured. If yes, fill in the Insurance Company Name and Plan ID#. Make sure to check if it’s a government-funded plan.
5. If applicable, complete SECTION 3: INTERCOLLEGIATE SPORTS by providing details about the injury and confirming if it was reported to the athletic department.
6. Finally, review all sections for accuracy before signing and dating the form at the bottom. Once completed, send it to NAHGA Claim Services as instructed.

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