Get Waiver Request Form For Students Learning - Office Of Student ... - Shb Umn

This guide will assist you in accurately completing the Waiver Request Form for Students Learning offered by the Office of Student Health Benefits. Following these detailed steps will ensure your waiver request is properly submitted and processed.

Follow the steps to fill out the waiver request form online.

1. Use the ‘Get Form’ button to obtain the waiver request form and open it in your browser or preferred document editor.
2. Complete the Student Information section. Provide your full name as it appears on official documents, your date of birth in the specified format (mm/dd/yyyy), your gender, and your University of Minnesota ID number. Additionally, include your current street address, city, state, and zip code, then select your campus location from the options provided.
3. Fill in your daytime phone number and email address, ensuring all contact information is accurate for effective communication.
4. Review the Acknowledgment section, where you affirm that if your waiver is approved, it will be valid for the specific term of your learning abroad experience. Read the Confidentiality Statement carefully to understand your rights regarding the information provided.
5. Sign and date the form in the designated area to confirm your submission. Ensure your signature matches the name provided earlier in the form.
6. Prepare the necessary documentation to accompany your waiver request, specifically proof of other health plan coverage, such as a copy of your health insurance card (both front and back).
7. Finally, submit your completed form along with the required documentation to the Office of Student Health Benefits, either by mail or fax, as indicated on the form. Make sure to keep a copy of the completed form for your records.

Complete your waiver request form online to ensure your health coverage needs are met during your learning abroad experience.