# UHIP Coverage Request Form

**Source**: https://dnn.uottawa.ca/en/Utilities/Multiform/IO/UHIP-Coverage-Request-Form
**Parent**: https://www.uottawa.ca/study/international-students/university-health-insurance-plan-uhip

General Comment

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This form is to be used by international students to request UHIP coverage if they have enrolled in courses (which activates their uOttawa email) and see that they were not charged UHIP fees as **[eligible students](https://www.uottawa.ca/current-students/uointernational/health-insurance)**.

Student information

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Student Number**\***

First Name**\***

Last name**\***

uOttawa Email Address**\***

Please indicate your current status**\***

Select
Canadian or Permanent Resident Living Abroad
Coverage Extension (Thesis Submission, Waiting for Graduation)
Expired Diplomatic Status
Permanent Resident Applicant
Other

*Specify, if 'Other'*

Comments

Attachment

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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.