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George Washington University
STUDENT HEALTH INSURANCE PLAN

Spring Waiver Appeal Form
2023-2024 Academic Year

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

The spring waiver appeal deadline is April 30, 2024.

Please note, your George Washington student ID# begins with a "G" followed by 8 digits.

 (MM/DD/YYYY)