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

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.

General Release of Liability Form

Create a liability form for any and all of your needs. Works on all desktop, tablet, and mobile devices. Drag and drop to customize. Collect e-signatures.

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.

Release of Liability Form

Create a release of liability form to ensure your company is covered in case of an accident. Signable on any type of device — desktop, tablet, and mobile friendly.

Free Non-Compete Agreement Template

Create a free non-compete agreement with Jotform Sign. Easy to customize and share. Converts to a PDF document. Fill out and e-sign on any device.

Doctors Note Template

Create a doctor’s note for your medical practice. Sign and send to your patients. Works on mobile, tablet, and desktop devices. Drag and drop to design.

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.