School of Health Education

Health Education Building 103
1705 Hoffman Street
Madison WI 53704

CALL: (608) 246-6065 or (800) 322-6282 ext. 6065

Monday - Friday: 8 a.m. - 4:30 p.m.

Student Accident Insurance Request Form

Submit the request form below, to enroll in student accident insurance coverage. 

You must submit a new form for each term you are requesting insurance.

The cost is $13 per semester and the nonrefundable fee will be posted to your Madison College student financial account. 

A variety of programs at Madison College require students to have basic health/accident insurance for clinical participation. By checking "Yes" in your CastleBranch account, you are indicating you agree to maintain coverage throughout the duration of your clinical experience(s), and you understand that Madison College cannot assume any liability or financial obligation for students’ health care.                                                                     

Please enter your telephone number in this format: 6081234567
Fall 2017: 08/28/2017; Spring 2017: 01/01/2018