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FORMS & DOCUMENTS

Please find below some useful forms & documents related to your Health & Dental Plan



  • Claim Forms
  • Info Brochures
  • Registration Forms
  • Other Plan Forms

For instructions on how to Make a Claim, please go HERE.

Health Claim Form

Use this form to claim for Drug, Extended Heath & Vision claims.

 

Dental Claim Form

Take this form to your dentist for completion before submission.  Note that we recommend students show their dentist their Health Plan Card and have the dental office submit their claim electronically, or request a "Standard Dental Claim Form" in lieu of using this form.

 

Travel Claim Form

Use this form for any emergency health claims while traveling outside of your province of residence or Canada.

 

Lost Luggage Claim Form

If you're traveling and your luggage is lost, use this form

 

Trip Cancellation Form | Limitations & Exceptions

If you have to cancel your trip, you can use this form to make a claim as long as your reason for cancellation is in line with the limitations and exceptions.

 

Accident Claim Form

If you have been involved in an accident and need to claim under the Accident Policy of your coverage, use this form.

Health & Dental Plan Brochure 2017-2018 | 

Find all the details for your Health & Dental Plan listed in this document

 

Travel Brochure | Travel Exclusions

Find the details of your 365 day travel coverage and a removable emergency travel card

 

OHIP+ Information Page

Find out important information regarding the new OHIP+ and what it means for YOU!

All opt-in requests are processed online during the Opt-In period for the term you begin your coverage.  Please visit the Online Opt-In for more details.

Status Change Form

This form is used for students who need to update their personal information where it related to name changes, relationship changes, etc.

 

Special Authorization Request Form

This form is used for students requesting special authorization for a specific drug to be covered under the plan. For students requesting a CNS Cap Removal, or Monitored Medication Request, please contact Student VIP directly.  Note that submission of this form does not guarantee your request will be granted.

 

Direct Deposit Registration Form

You can use this form to register for Direct Deposit of your claim refunds to your bank account.  You can also login to the RWAM Member Portal to do this online. 

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