Download Forms

• Accidental Dental Claim Form
• Ambulance/Medical Transfer Claim Form
• Assisted Care Nursing Recommendation Claim Form
• Attending Physician's Report
• Dental Claim Form
• Direct Deposit Application Form
• Extended Health Benefit Claim Form
• Group Travel Health Claim Form  (benefits through group plan)
• Health Spending Account Claim Form
• Hospital Claim Form
• Orthotics, Orthopedic Shoes and Modifications Claim Form
• Out of Country Medical and Hospital Services Authorization Form
• Individual Travel Health Plan Claim Form  (individually purchased policy)
• Trip Cancellation Claim Form
• Vision Care Claim Form

• If you have an individual travel health policy and need to submit a claim for travel in Canada, print the Individual Travel Health Plan Claim Form.
• If you have an individual travel health policy and need to submit a claim for travel outside of Canada, print the Individual Travel Health Plan Claim Form and the Out of Country Medical and Hospital Services Authorization Form.
• If you have an employer travel health plan and need to submit a claim for travel in Canada, print the Group Travel Health Claim Form.
• If you have an employer travel health plan and need to submit a claim for travel outside of Canada, print the Group Travel Health Claim Form and the Out of Country Medical and Hospital Services Authorization Form.
• If you need to make a claim for trip cancellation benefits, print the Trip Cancellation Claim Form and the Attending Physician's Report (please remember to insert the policy purchase date on the Attending Physician's report)