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MGH INSTITUTE OF HEALTH PROFESSIONS
Student Health Insurance Plan

2025 Fall Term Waiver Form

The waiver form is effective September 1, 2025 and is good through April 30, 2026.

You must complete all pages of this waiver form in order to waive the Institute's Student Health Plan. Failure to successfully submit the waiver form by the deadline of September 1, 2025, will result in the following:

  • You will be enrolled in the MGHIHP Student Health Plan.
  • You will be responsible for paying the full semester premium.
  • Also, until you have paid the full semester premium:
    • you will not be allowed to register for future semesters;
    • your grades and transcripts will be held; and
    • access to your student record on IONLINE will be limited.

Your student ID is 7 digits, including any leading zero.

Asterisk (*) denotes required field

STUDENT INFORMATION

 
 (MM/DD/YYYY)