Insurance and Immunization Forms

Online Insurance Form

Lesley University and Gallagher Koster Insurance Agency have an online procedure for the 2008/2009 academic year.  All full-time or three quarter-time students will be auto-enrolled into the Student Insurance according to their academic status as determined by the Lesley University Registrar records.  The online form to enroll or waive the insurance can be found at www.gallagherkoster.com.  Notifications will be sent to all students as they enroll reminding them of this process, including instructions on how to waive or confirm enrollment in the insurance.  When you complete the online enrollment or waiver form, print your confirmation for your record.  Please allow a few days for the online form to be processed and the changes to be reflected on your Student Account.  For Fall 2008, the deadline to waive is August 15, 2008.  If you miss the Auguster 15 deadline, and would like to petition to waive the insurance, you must now contact Gallagher Koster Insurance and submit online waiver form at www.gallagherkoster.com.

Immunization Form

Due before your arrival on campus.

• Immunization Sheet
• Meningitis Information Sheet and Waiver Form
• Request form for Immunizations