Forms

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Admin, Enrolment
Appointment of Beneficiary(ies)
Change
Change Application
Change
Change Application for Early Retirees
Admin
Consent to Disclose Personal Information
Admin, Claim
Coordination of Benefits Information
Claim
Dental Care Claim
Admin, Enrolment
Désignation de bénéficiaire(s)
Admin, Claim
Early Refill Request
Claim
Emergency Out-of-Country Claim
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Ankylosing Spondylitis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Chronic Hepatitis C
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Crohn's Disease/Colitis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Multiple Sclerosis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Psoriasis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Psoriatic Arthritis
Enhanced Special Authorization Request
Enhanced Special Authorization Request: Rheumatoid Arthritis
Claim
Extended Health Care and Vision Care Claim
Admin, Claim
Greater Than 100 Day Supply of Prescription Drugs Request
Enrolment
Late Applicant Medical Information & Health Assessment - Supplemental Package
Admin, Enrolment
Oral Health Exception Request
Admin, Enrolment
Oral Health Exception Request: Permanently Disabled Over-age Dependant
Enrolment
Supplemental Package Application
Change
Supplemental Package Change Application