mvd-optout | Gallivan

Virtual Health Care is always available! myvirtualdoctor is your virtual health care service providing eligible students unlimited 24/7 access to licensed health experts, including nurse practitioners and doctors.

myvirtualdoctor Opt-Out Application

Deadline to submit applications

Students starting in September must submit the opt-out form by October 5^th. Students starting in January must submit the opt-out form by February 5^th. Students starting their program at any other time of year, the deadline to complete an opt-out form is 30 days from their program start date.

This is an annual opt-out. All students who choose to, and are eligible to waive myvirtualdoctor each year they are an eligible student at NSCC, must submit the opt-out form upon the anniversary of their original program start date.

Important notes:

The student is given one (1) opportunity to opt-out of myvirtualdoctor each year. The student is only able to opt-out during their initial opt-out period or the opt-out period that corresponds with their enrolment anniversary.
Once you opt-out you will not be able to re-enroll in the program until your enrollment anniversary.
Approval of the Student’s opt-out will result in the myvirtualdoctor fee being credited/or refunded according to the school's policy.
NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan's mandatory fees, should they miss the applicable opt-out deadline.
Once you complete the opt-out form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting an opt-out request.

Add donotreply@gallivan.ca to your address book. Please do not reply to this email.

Questions? Please contact your Benefit Plan Office: nsccplan@mystudentplan.ca

myvirtualdoctor Opt-Out Form

Student Information

Student ID Number

Email Address

Confirm Email Address

First Name

Last Name

Date of Birth

Date Month Field Date Day Field Date Year Field

Postal Code

Phone Number

Phone Area Number Phone Local Number Phone Digits

Program Name

Program Start Date

Date Month Field Date Day Field Date Year Field

Required Direct Deposit Information

Please enter your financial institution's Transit Number, Institution Number, and Account Number. (*mandatory fields)

** Please do not enter any dashes or spaces **

Transit #

Transit # must be at least 5 digits long * Required

Institution #

Institution # must be at least 3 digits long * Required

Account #

Account # must be numeric * Required

Address: Institute of Technology Campus
Room A-282.3, A-Wing, 2nd Floor
(across from Student Services)
5685 Leeds Street
Halifax NS
B3J 2X1

Monday to Friday
From 11:00am to 9:00pm AST
Phone: 1-877-746-5566
Extension 7249