UHIP Coverage Request Form

General Comment

This form is to be used by international students to request UHIP coverage.

Student information

Student Number *

First Name *

Last name *

uOttawa Email Address *

Please indicate your current status *

Specify, if 'Other'

Comments

Attachment

Please make sure to upload proof of your current status:

Supporting document - Proof of your current status (Max file size: 2 Mb) *

Accepted formats : jpg, jpeg, png, doc, docx, pdf.Choose fileChosen file:

Please leave this field blank:

After evaluation of your file, we will confirm by email the creation or extension of your UHIP coverage, if eligible.