• About UHCS
• Access to Care
• Medical Services
• Counseling Services
• Sports Medicine
• Health and Wellness
• Learning Disabilities Program
• Northeastern University Student Health Plan (NUSHP)
  • Highlighted Benefits
  • General Information
  • Effective Dates and Costs
  • Waiver Deadlines
  • Enrolling in NUSHP after waiving
  • Forms
• Violence Support, Intervention, and Outreach Network (ViSION)
• Forms
• FAQs

Forms

The following files are in PDF format. A free PDF reader, Adobe Acrobat, is available for download.

• BCBS Claim Form
• BCBS International Claim Form
• Petition to Enroll in NUSHP Form
• NUSHP Late Waiver Request Form
• NUSHP MidYear Enrollment Form
• UHCS Access Request Form
• Mid Year Adjustment Form

Email: NUSHP@neu.edu 
Address:
Student Health Plan Manager
Northeastern University
135 Forsyth Building
360 Huntington Avenue
Boston, MA 02115
Phone: 617-373-8007  
Fax: 617-373-7340