STUDENT HEALTH AGREEMENT

HEALTH INSURANCE AGREEMENT

It is Mississippi University for Women's policy that nonimmigrant international students must have health
insurance to be enrolled at MUW. International students must purchase an insurance plan independently
from the university. Proof of insurance coverage must be submitted to the Office of International Programs
within one week of each term starting.


IMMUNIZATION/X-RAY REQUIREMENT

It is obligatory that all international students submit records of 2 vaccinations for MMR (measles, mumps,
and rubella) and the translated report of a chest x-ray. X-rays may be done in Columbus for $25.
Translated records may be submitted prior to registration, though the Office of International Programs must
receive all documents within two weeks of registration.


I agree to the policies/requirements mentioned above.


_________________________ _________________________ ______________
NAME SIGNATURE DATE
Please Print or Type



Please send this form to International Programs.


By Post:
International Programs
Mississippi University for Women
1100 College Street MUW-1613
Columbus, MS 39701-5800
U.S.A.

By Fax:
(662) 241-7481


Enrollment is contingent on the receipt of this health agreement.
I-20s are not issued until International Programs receives this agreement.
Cost Subject to Change