CHECK LIST - Shawnigan Lake School
CHECK LIST - Shawnigan Lake School
CHECK LIST - Shawnigan Lake School
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HEALTH CARE COVERAGE FOR 2013 - 2014<br />
STUDENT NAME: __________________<br />
PARENT NAME: ___________________<br />
Health Care coverage must be in place for your son/daughter before he/she commences classes<br />
at <strong>Shawnigan</strong> <strong>Lake</strong> <strong>School</strong>. To do so, please complete one of the following four options.<br />
OPTION 1<br />
CANADIAN STUDENTS<br />
If your son/daughter has an active Provincial Medical Number, enter this information below.<br />
Please note that many provincial Health Ministries require written notification if your child is<br />
attending school outside of the province. The <strong>School</strong> will provide you with an enrollment letter<br />
but it is your responsibility to notify the Ministry of Health in your province.<br />
MEDICAL NUMBER<br />
PROVINCE<br />
Signature<br />
Date<br />
OPTION 2<br />
INTERNATIONAL STUDENTS<br />
Health Insurance is available through the BC Medical Services Plan (MSP),<br />
http://www.health.gov.bc.ca/msp/ this plan provides coverage for all physician related care,<br />
medical testing and hospitalization with no deductible fee, cost $64.00/month billed to your<br />
account.<br />
* PLEASE NOTE: temporary insurance coverage is required for 90 days from your<br />
son/daughter's arrival in BC until MSP begins coverage. This can be provided through<br />
Johnson Fu Insurance Agency at cost of $64.00/month billed to your account.<br />
Yes, I wish to have my son/daughter apply for temporary insurance and British Columbia<br />
Medical Insurance.<br />
IMPORTANT In addition to your signature, COPIES of the student's Passport and Canadian<br />
Student Visa are required. Please attach copies or bring documents to Opening Day and meet<br />
with the Nurse.<br />
Signature<br />
Date<br />
Safeguarding personal information is a fundamental concern of <strong>Shawnigan</strong> <strong>Lake</strong> <strong>School</strong>. The <strong>School</strong> does not sell, lease or trade<br />
information about you to other parties and is committed to meeting or exceeding the privacy standards established by British<br />
Columbia’s Personal Information Protection Act (PIPA) and any other applicable legislation. A full copy of the <strong>School</strong>’s Privacy<br />
Policy is available from the Business Office.<br />
SHAWNIGAN LAKE SCHOOL<br />
1975 Renfrew Road ▪ <strong>Shawnigan</strong> <strong>Lake</strong>, BC V0R 2W1 ▪ Phone (250) 743-5516 ▪ Fax (250) 743-6200
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