Forms & Guides

Immunization records submitted to our office must be signed and stamped by your doctor. You may use this form as a template, or your doctor may provide their own version.

• Immunization Form
• TC Medical Exemption Form
• TC Religious Exemption Recertification Form
• TC Influenza Religious Exemption Form
• TC Influenza Medical Exemption Form
• Plan Detail and Member Responsibility

Plan detail and member responsibility for 2020-2021 plan year.

• 2020-2021 Columbia University Summary of Benefits and Coverage
• 2020-2021 Columbia University (Affliate) Plan Design and Benefits Summary

Please refer to affiliate rates for Teachers College students.

• 2020-2021 Columbia University Aetna Dental PPO Plan Design Benefits Summary