Do not hit your back button

Welcome to the Online Waiver for Mount Saint Mary's University Students.

Please read before starting:

It is highly recommended that you review the FAQ and Help page (will open a new window) before you begin so you know what information you will need to provide to complete and submit the waiver application. Once you submit your Student ID and date of birth below, you will only have 15 minutes to complete and submit the waiver application. If you are not able to complete the waiver application in that time, you should close your web browser and come back once you have the information you need to complete it.

Before you begin, you need to be prepared to answer the following questions:
  • Insurance Company Name
  • Insurance Company Phone #
  • Subscriber's Name
  • Insurance Subscriber/Medical ID #
  • Subscriber's relationship to you
  • Does your plan provide emergency care within 150 miles of Mount Saint Mary's University?
  • What is your plan's annual deductible?
  • Does your plan have an annual benefit maximum?

Please enter your Student ID number and date of birth below. Your student ID number must contain 7 digits. If your student ID number is less than 7 digits, add leading zero(s).

NOTE: ONLY ADN students enrolled in 7 units or more and students enrolled in 9 units or more are eligible to waive. If you are enrolled in less than 9 units, you cannot submit the waiver form.


This form must be submitted no later than the published Financial Clearance Deadline for your program.