InsMed Insurance Agency
The Path for Your Insurance Needs

service request

Weill Cornell School of Medicine


You have a 60-day window preceding graduation and 30 days after your graduation to enroll in the long term disability conversion program. This form will enable you to request information to address specific issues you may have concerning your portable disability insurance program.

Name *
Date of Birth
Date of Birth
Would you like to receive information about the important issues of disability through your email?
Would you like to receive a personalized proposal about your supplemental coverage opportunities?
Would you like us to review any other personal coverage you may maintain?