StudentVIP.ca

Forms and Documents

On this page you will find forms that are useful when using your plan including coverage summaries.

If you need assistance completing a form, e-mail our member experience team and we will be happy to help you! Please use the Live Chat feature or e-mail Student VIP at info@studentvip.ca.

Benefits Booklet

Claim Form

Brochures

Request Forms

Click to view your International Health Plan Policy

Medical Claim Form
Please fill out this form if you have paid upfront for any of your medical services and have the receipt(s) to submit as a claim.

International Health Plan Brochures: English | Arabic | Spanish | Portuguese

International Health Plan Policy: English

Medical Pre-Authorization Form
This form can be completed to confirm eligibility of a claim prior to a student seeking the service.
Once completed please send this form to stclair@medavie.bluecross.ca

Direct Deposit Form
Use this form to have your eligible claim payments deposited into your bank account. You must have a Canadian bank account in order to complete this form.

Special Authorization Request Form
This form is used for students requesting special authorization for a specific drug to be covered under the plan. For students requesting a CNS Cap Removal, or Monitored Medication Request, please contact Student VIP directly. Note that submission of this form does not guarantee your request will be granted.