July 30, 2010  
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Online Forms

It's as easy as a click. The following forms are available to print, fill out, and fax or mail in. They are provided in Adobe Acrobat PDF format. If you do not have Acrobat Reader, download it free of charge from Adobe's web site.

Form CategoryForm Name
Enrolment & Changes
    Plan Member Enrolment Form
    Notice of Change Form
    Salary Change Form
    Waiver of Coverage Form
    Application for Conversion Into Individual Life Insurance
    Morneau Conversion Program Application
    Morneau Conversion Program Brochure
    Non-Smoker Questionnaire
    Notice of Return to Work Form
    Statement of Health
    Statement of Health for Dependants
Life Claims
    Proof of Death – Physician’s Statement
    Application for Group Life Benefits
Disability Claims
    Attending Physician's Disability Benefits Statement
    Job Description Form
    Application For Benefits Employer’s/Employee’s Statement
    Waiver of Premium Claim Form
Health & Dental Claims
    Audio Claim Form
    Authorization Form for Prosthetic/Orthotic Devices/Medical Equipment/Oxygen
    Authorization Form for The Services of An R.N., R.N.A., R.P.N., P.N.A. or L.P.N., Trained Attendant or Homemaker
    Claim Form for Related Health Professional Services
    Claim Submission Form
    Dental Claim Form
    Dental Pre-treatment Form
    Hospitalization Claim Form
    Special Claim Services Cost Plus Form
    Travel Insurance Claim Form
    Vision Care Claim
AD&D Claims
    Accidental Dismemberment Claim Form
    Accidental Dismemberment Claim Form Consent & Authorization
    Application Form Group Life Benefit
    Attending Physician's Statement

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Last updated on:  Friday, September 24, 2004  Page: 

This information is not intended for use without professional advice. While we have attempted to make this site as accurate as possible, it is only a summary. For more information, see our disclaimer.

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