Barnard College
STUDENT HEALTH INSURANCE PLAN

​Annual Waiver Form
2017-2018 Academic Year

Please remember the following:

• The waiver process is annual. You must make a selection before the beginning of the first semester of each academic year in which you are registered.
• Barnard College will review all waivers in order to ensure compliance with Barnard College waiver policy requirements. Please be sure to have a copy of your insurance policy as you may be asked to provide this documentation.

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