Skip to main content Skip to main menu

Wake Forest University School of Medicine
STUDENT HEALTH INSURANCE PLAN

Dependent Enrollment Form 
2023-2024 Academic Year

Students who are eligible for the Wake Forest School of Medicine Student Health Insurance Plan (SHIP) may use this form to add eligible dependents to the plan. Eligible dependents are the spouse, domestic partner, or child(ren) of a Wake Forest School of Medicine student who is also enrolled in the SHIP. 


To continue the enrollment process, please fill out the required fields below:

 (MM/DD/YYYY)