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

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

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.

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

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.

Preview

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.

Preview

Summer Camp Permission Slip

Create summer camp permission slips for parents of your campers. Intuitive form building. Drag and drop to design. Works on desktop, tablet, and mobile devices.

Preview
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.