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.

Related templates

Hospital Discharge Template

The essence is that you can easily check the information saved in the PDF document to ensure a patient can be discharged. The hospital discharge letter template here can be modified to suit your taste.

Professional Physical Therapy Consent Template

Create a professional physical therapy consent form. Collect e-signatures on any smartphone, tablet, or desktop. Easy to customize and share.

Online Therapy Consent Template

Create an online therapy consent form to gather patient consent. Sign and fill out on any device. Drag and drop to fully customize. No coding knowledge required.

Professional Medical Release Template

Create a professional medical release template. Great for medical practices and therapists. Collect signatures online. Converts to PDF. Easy to customize and share.

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.

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.

These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.