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Office of International Programs


Office of Study Abroad


ODU International Health Insurance Coverage Certification Form

Please fill out the following form and click "calculate". Then print the form, sign and date it, and turn it in to the Office of Study Abroad.

Old Dominion University policy #5101 requires that all students, faculty, administrators and staff participating in international education abroad initiatives -- whether of a credit or non-credit nature -- carry complete international health insurance coverage for the duration of their program.

Name:
UIN:
Program Name:

I certify that I will attend one of the common programs listed on the health insurance price list. The amount listed for that program is

I certify that the program in which I will participate includes international health insurance coverage satisfying ODU's International Health Insurance Coverage Requirements for Study Abroad

I certify that I will attend a study abroad program that does not include international health insurance coverage satisfying ODU's requirements.

  • My program start date is:
  • My program end date is:
  • My total program days are:  
  • Including two travel days, I need   days of international health insurance coverage.
  • At the current rate of   per day, my international health insurance will cost:  

Total Health Insurance Cost:

I understand that, unless specifically exempt, I am responsible for purchasing international health insurance coverage through the ODU Office of Study Abroad at the above cost.

Student Signature:___________________________________________
Date:______________________________________________

 



News and Announcements

Boren Awards Information Webinars Scheduled for Undergraduate and Graduates

Study Abroad moves to Spong Hall

Study Abroad Deadlines

Information Sessions

Boren Awards - Scholarships and Fellowships for International Study

Incoming Exchange Students: Pre-registration Information

Weiner International Affairs $2000 Scholarship





Resources

How to Fund Your Study Abroad Experience

Student Fellowships for International Study/Research

Passport Application Information

Travel Information

CDC Travelers' Health Information

Digest for Student Funding/ Job Opportunities and Conferences

International Career Advantage Program

Forms





Photo Gallery

View ODU students' photographs from abroad

See a YouTube video of one study abroad student's experience





About Study Abroad

Mission Statement

Frequently Asked Questions

Interest Form

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