OHIP Information Form

Please fill in all required fields correctly and upload your Ontario Health Insurance Plan (OHIP), University Health Insurance Plan (UHIP), or Interim Federal Health Program (IFHP) card. Ensure files are clear and accurate. When you submit this form, it will not automatically collect your details like name and email address, unless you provide it yourself.

OHIP/UHIP/IFHP Information Form

URL
This field is for validation purposes and should be left unchanged.
Name*
First Name Last Name
Student Number:*
ex. 040-123-458
Personal Email*

Please use an email address that you check frequently.
OHIP/UHIP/IFHP Card Issue Date*
OHIP/UHIP/IFHP Card Expiry Date*
Please upload a copy of your OHIP/UHIP/IFHP card*
Accepted file types: pdf, jpg, png, Max. file size: 3 MB.
On-Shore Health Insurance Acknowledgement*
- By submitting this completed form, I confirm that I have reviewed, understand, and agree that:
I acknowledge and understand that OHIP, UHIP and IFHP do not offer the same coverage as the mandatory College health insurance and that by opting out, I may lose certain benefits. I accept full responsibility for this loss of coverage. In return for being allowed to opt out and receive a refund, I waive and release the College and its representatives from any claims related to medical or health care costs while I am a student. I confirm that I have reviewed the differences in coverage and understand that I am giving up certain benefits and rights by opting out.

OHIP Information Form

OHIP/UHIP/IFHP Information Form

Ottawa

Pembroke

Online

OHIP/UHIP/IFHP Information Form

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