UHIP Re-Enrollment Form

This form is only to be completed by international students who previously had UHIP coverage in the 2024-2025 academic year but were removed from the plan because they did not start or stopped their studies. Such students must be actively enrolled in degree studies in the Summer 2025 term to qualify for UHIP through the submission of this form.

Please only complete this form once you have arrived in Canada. You do not need UHIP to enter Canada.

If you have dependants, please email uhip@yorku.ca to receive instructions to re-enroll your dependants into UHIP.

Name Name * First Last
Student Number *
Must be 9 digits. Currently Entered: 0 digits.
YORKU Email Address *
Date of Birth Date of Birth * / MM / DD YYYY
Gender *

Gender Female Male Undisclosed Non-binary
Reason for your absence or need to re-enroll in UHIP *

Reason for your absence or need to re-enroll in UHIP Student exchange Immigration delay Illness End of Canadian federal or provincial health insurance coverage Deferral of or withdrawal from studies for non-immigration reasons (ex. financial, course unavailability, etc.)
Most recent date that you arrived in Canada, or, if your Canadian federal or provincial health insurance has expired, the date your insurance coverage ended Most recent date that you arrived in Canada, or, if your Canadian federal or provincial health insurance has expired, the date your insurance coverage ended * / MM / DD YYYY
Please upload your valid study/work permit: *

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