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1305 Dares Beach Road Prince Frederick, MD 20678 P 4435508000 F 4102861358 www.calvertnet.k12.md.usDr. Andra Townsel Superintendent of SchoolsInsurance Waiver FormDate:___My student (name)___ Grade:___,
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01
Download the school-insurance-waiver-formpdf from the school's website or request a copy from the school office.
02
Read the instructions carefully to understand the information required to fill out the form.
03
Fill out your personal information such as name, address, phone number, and student ID.
04
Provide details of your current health insurance coverage including the policy number and the name of the insurance company.
05
Sign and date the form to certify that the information provided is accurate.
06
Submit the completed form to the designated school administrator or office for processing.

Who needs school-insurance-waiver-formpdf?

01
Students who already have health insurance coverage and wish to waive the school's insurance policy.
02
Students whose parents or guardians have health insurance that covers the student.
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The school-insurance-waiver-formpdf is a document used by students or their guardians to opt out of school-provided insurance, typically because they have their own insurance coverage.
Students who wish to decline the school-provided insurance coverage and have alternative health insurance are required to file the school-insurance-waiver-formpdf.
To fill out the school-insurance-waiver-formpdf, individuals must provide their personal information, insurance details, and sign the form to confirm that they have adequate alternative insurance coverage.
The purpose of the school-insurance-waiver-formpdf is to officially document a student's request to waive school-provided insurance coverage, ensuring they are aware of their responsibilities and available health options.
The form typically requires information such as the student's name, contact information, insurance provider details, policy number, and a signature from the student or guardian.
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