Vocational Student Health and Dental Opt-Out

Use this form to opt-out of the TRUSU Health and Dental Plan if you are a vocational (mostly trades) student. You will need to provide proof of your existing coverage.

1. Contact Information *This question is required.

First Name

Last Name

Student Number

Email Address

Phone Number

2. Program Information *This question is required.

Program of Study eg. Electrical, Welding, Heavy Duty Mechanic, Health Care Assistant, Administrative Assistant, Cook Level 1, etc

Program Start Date Opt-out requests must be received within 30 days of the program start date in order to be eligible. This question requires a valid date format of DD/MM/YYYY.

calendar

Based on the information provided you are not a vocational student and cannot complete this opt-out form. You must follow the instructions for academic (semester-based) students.

Find out more at https://trusu.ca/services/health-dental/opting-out/ or contact the Services Coordinator at services@trusu.ca

3. Existing Health and Dental Plan Information *This question is required.In order to opt-out of the TRUSU Extended Health and Dental Plan, you need to provide proof of coverage with another equivalent health and dental plan.

Insurance Company Name

Plan or Policy Number