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Salve Regina University
STUDENT HEALTH INSURANCE PLAN

Annual Waiver Form
2026-2027 Academic Year


By completing the waiver form you are waiving the annual 26-27 insurance charge on your bill and confirming you have your own comparable health insurance coverage in place. Waivers do not carry over each new academic year and must be completed by the posted deadline at the start of each new academic year. 

TO CONTINUE THE WAIVER PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

Asterisk (*) denotes required field

STUDENT INFORMATION

 
 (MM/DD/YYYY)