Student Field Placement Information
If you are responsible for coordinating student field placements please use this site as a resource for the required forms and documents you will need.
In addition, a guideline document has been prepared to provide an overview of all of the necessary elements to ensure appropriate coverage in the event a student is injured while on placement at a placement host employer location. The Insurance Guidelines for Coordinators of Student Placements is intended as a reference for all schools involved in the coordination of work / education placement programs and is also available through the Publishing Centre as a package.
This guideline contains instructions for coordinators and includes all of the forms and letters that are required to establish proper coverage for students on placement. The same forms and reference materials are listed below in either pdf or downloadable document versions for use by placement coordinators.
- Student / Learner Placement Consent (Appendix A) (.docx)
- Post-secondary Student Unpaid Work Placement Workplace Insurance Claim (Appendix B)
- Sample Letter to Placement Host Covered by WSIB (Appendix C) (.docx)
- Letter of Authorization to Represent a Placement Host (Appendix D) (.docx)
- Sample Letter to Placement Host Not Covered by WSIB (Appendix E) (.docx)
- CHUBB Accidental Medical Claim Form (Appendix F)
- CHUBB Authorization to Obtain Information (Appendix G)
- CHUBB Employer Administrator Statement Form (Appendix H)