Fairleigh Dickinson University
STUDENT HEALTH INSURANCE PLAN
Annual Waiver Form
2025 - 2026 Academic Year
You may waive coverage under this plan if you have health insurance that meets Fairleigh Dickinson University’s insurance plan requirements. You will need to provide information about your other coverage.
The waiver appeal deadline is October 14, 2025.
PLEASE FILL OUT THE REQUIRED FIELDS BELOW:
