Get Student Verification Form - Delta Dental Of Colorado

Completing the Student Verification Form for Delta Dental Of Colorado is a crucial step in ensuring your dependent's eligibility for dental coverage. This guide will provide you with clear, step-by-step instructions to assist you in filling out the form accurately online.

Follow the steps to complete the Student Verification Form online

1. Click 'Get Form' button to access the form and open it in your preferred editor.
2. Fill in the subscriber's information, including the subscriber's name, group number, and Social Security Number (SSN). Ensure that all details are accurate to avoid processing delays.
3. Provide the over-age dependent's name and date of birth. Confirm that this individual meets the criteria for being an over-age dependent based on your group’s contract.
4. In the certification section, review the requirements for dependent eligibility. Acknowledge that the dependent must be a full-time student, financially dependent on the subscriber, and unmarried.
5. Sign the form agreeing to the conditions stated, including the recognition of responsibility for notifying Delta Dental of any changes in dependent status.
6. If needed, include additional documentation for dependents who are unable to support themselves due to physical or mental incapacity.
7. Review all provided details to ensure accuracy before finalizing the form.
8. After completing the form, save any changes, download a copy for your records, and print it if necessary. Share or return the signed form to Delta Dental as instructed.

Complete your Student Verification Form online today to ensure continuous dental coverage for your dependent.