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MGH INSTITUTE OF HEALTH PROFESSIONS
Student Health Insurance Plan

2026-2027 Annual Enrollment Form

This enrollment form is for coverage from May 1, 2026, through April 30, 2027, as long as you remain eligible for the Summer, Fall & Spring Terms. 

Your student ID is 7 digits, including any leading zero.

Please do not use dashes when submitting your SSN. If you are an international student and do not have a SSN, please enter "999999999" in that field.

Asterisk (*) denotes required field

STUDENT INFORMATION

 (MM/DD/YYYY)