Packet A: Bursar Office Forms

1. Optional Fees Forms (2022-2023)
2. Student Accident and Sickness Plan Form (2022-2023)
3. Title IV Authorization Form (2022-2023)

1. Optional Fees Forms (2020-2021)
2. Student Accident and Sickness Plan Form (2020-2021)
3. Title IV Authorization Form (2020-21)

Submit scanned forms (no camera screen shots) via email: nobursar@lsuhsc.edu

1. The Optional Fees and the Student Accident and Sickness Plan Forms are required and must be submitted together. (One form will not be accepted without the other).
2. All students must have personal health insurance, either individually or through LSUHSC. If you have personal health insurance, the front and back of the insurance card must be submitted with the Student Accident and Sickness Plan Form.
3. Student Health Insurance and/or Needlestick/Splatter premiums cannot be deducted from Federal Aid even with permission. Deductions of these fees will be from other non-federal funds. All students are required to purchase the Needlestick/Splatter coverage at a cost of $18.02 for the semi-annual premium. This fee will appear on the Tuition and Fee bill. Financial Aid, TOPS, etc. does not cover the Needlestick/Splatter premium fee. Needlestick/Splatter insurance cards will be mailed to students after tuition and fees are paid.