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Graduate Appointee Insurance Program (GAIP)
Forms and Resources

All forms are in .pdf format.

Claim Forms
View list of LifeWise claim forms at:
http://student.lifewiseac.com/uw/gaip/Forms.aspx
Temporary ID card

LifeWise ID cards are issued within a few days of enrollment. You may also download and print a temporary, personalized ID card from the LifeWise website, or contact LifeWise for further assistance.

Mail Order Forms
Medical Plan Network Providers
Petition Forms
Dependent Enrollment Forms

The following forms are available at the LifeWise website under "Dependent Forms":

  • Enrollment and Change Form
    Update member information such as address or remove a dependent from coverage on your plan.
  • Tax Status Declaration
    Declare your tax status when adding a domestic partner for coverage on your plan. This form is required to add a domestic partner.
  • Dependent Verification
    List of documentation required when adding dependents for coverage on your plan.
  • Determine Dependent Status Worksheet
    Determine the correct tax status to declare on the Tax Status Declaration form when adding a domestic partner for coverage on your plan.
  • Marriage Declaration
    Use this form when adding a spouse or domestic partner for coverage on your plan. This is a required form to add these dependents.
Other Resources
Address Updates

GAIP
Topics