Salve Regina University
STUDENT HEALTH INSURANCE PLAN
2024-25 SPRING SEMESTER WAIVER FORM
1/15/2025 - 8/15/2025
THE FALL WAIVER DEADLINE HAS PASSED. BY COMPLETING THIS WAIVER FORM YOU ARE WAIVING THE SPRING SEMESTER CHARGE ONLY. STUDENTS WHO FAILED TO COMPLETE THE FALL WAIVER WILL BE RESPONSIBLE FOR THE FALL SEMESTER PREMIUM.
TO CONTINUE THE WAIVER PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:
