Full Time Training in Anaheim Students Online Waiver

This form must be submitted no later than -  5/31/2019 

Please read before starting:

It is highly recommended that you review the FAQ and Help page before you begin so you know what information you will need to provide to complete and submit the waiver application. Once you enter your name below, you will only have 15 minutes to complete and submit the waiver application. If you are unable to complete the waiver application in that time, you should close your web browser and come back once you have the information you need to complete it.

Before you begin, you need to be prepared to answer the following questions:

  1. What is your plan’s annual deductible?
  2. Will your plan cover office visits, hospitalizations and prescription medications while you are in the Anaheim area?
  3. Who will pay for the cost of medical expenses not covered by your insurance (you, your parents, or your sending locality)?
  4. Should you be advised by the FTTA nurses, will you agree to seek care using your health care provider, even though there will be expenses involved?

Please enter your first name, last name, and middle initial below.

Products and services are offered through USI Insurance Services National, Inc. a wholly owned subsidiary of USI Insurance Services LLC. Products and services are underwritten by unaffiliated insurance companies. Some services require additional fees and may be offered directly through third-party providers.