Student Affairs SectionWaseda University

  2. Student life support
  3. Medical Fee Reimbursement System
  4. Application Method
  5. Application Formats

Application Method

Application Formats

Waseda University Student Health Promotion Mutual Aid Association application form list

  1. “Application for Reimbursement of Medical Fees”
    “Application for Reimbursement of Medical Fees”(Japanese) =>Example(Japanese)
  2. “Postal Application Form*”: Required when applying mail.
    “Postal Application Form*” (Japanese):  It’s a necessity to document if you want to submit by postal mailing.
  3. “Letter of attorney*”: Required when a proxy applies to the counter.
  4. “Application form for refund of Mutual Aid Association’s fee*”: Only for study abroad through official programs of the university, leaving the university in the middle of a semester, etc.

*: Copy of your Student ID (front only) must be affixed.

  • Documents filled out with a pencil or pen using special ink that is erased with friction, etc. shall not be accepted.
  • Applications and copies of receipts on which advertisements, etc. are printed on both sides or one side shall not be accepted.

[Important] It has been determined that the treatment at an osteopathic clinic, the treatment for acupuncture/moxibustion/massage, and the therapeutic orthosis will be outside of the scope of the medical fee reimbursement system from April 1st, 2022. For more information, please click here.

Also, refer to here if you are submitting the form by mail.

To apply for medical fee reimbursement

Precautions

Application by postalmail

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