Insurance Waiver Template

About this template

An insurance waiver is a legal document signed by an employee declining any offered health insurance coverage. With our free Insurance Waiver Template, you can securely collect e-signatures from employees who have chosen to opt out of your company’s health insurance plan. Simply share this form with signers via email and automatically receive the finalized document once it’s filled out and signed.

Customize the look and feel of this Insurance Waiver template in seconds with Jotform’s no-code builder. Drag and drop to add your company’s branding, edit the declaration of waiver wording, include dropdown and multiple choice fields, and more. Once your custom insurance waiver has been signed and instantly sent back to you, you can then print or save the finalized document for your records. Collect e-signatures on any device with Jotform Sign.

Disclaimer: The e-sign templates here are for informational purposes only. Jotform is not providing legal, financial, or other advice, or implying that the forms are legally valid in all or any jurisdictions. Before using any such template, consult an attorney and/or other applicable professionals to make sure that the form meets your needs, legally and otherwise.

Related templates

Simple Bounce House Waiver Template

Build a professional bounce house waiver for your event business. Works on all device types. No coding required. Easy to share and embed. Collect e-signatures.

Preview

Eyelash Extension Consent

Create professional consent forms for your eyelash extension business needs. Download responses as PDFs. Works on Android and iOS devices. Easy to customize.

Preview

Background Check Template

Create a custom background check form for your business. Converts into PDF. Easy to share and embed. Works on any device. Android and iOS compatible. No coding.

Preview

Interview Consent Agreement

Gather interview consent forms online. Can be filled out and signed on any device. Converts to a PDF instantly. Easy drag-and-drop customization.

Preview

Rent Ledger Template

Create a rent ledger agreement in seconds. Fill out and e-sign from any smartphone, tablet, or desktop. Easy to customize and share. Converts to a PDF.

Preview

NonProfit Donation Consent Template

Create a nonprofit donation consent form in seconds. Drag-and-drop to design and customize. Collect signatures from any smartphone, tablet, or desktop.

Preview