All Forms

Ottawa forms:

• Medical claim form (original receipts required, cannot be emailed or faxed)
• Dental claim form
• Pre-authorized deposit form (for health and dental claims)
• Pre-authorized payment form
• Short term disability claim form (contact the Coughlin Ottawa office for the corresponding forms)

Winnipeg forms:

• Medical claim form (original receipts required, cannot be emailed or faxed)
• Dental claim form
• Pre-authorized deposit form (for health and dental claims)
• Short term disability claim form (this form is for clients from the Winnipeg office only)