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All Forms

Quick Contact

Ottawa office
466 Tremblay Road
Ottawa, ON K1G 3R1

Tel: 613-231-2266
Fax: 613-231-2345
Toll Free: 1-888-613-1234

Winnipeg office

Mailing address:
P.O. Box 764
Winnipeg, MB R3C 2L4

Street address:
Unit 1391,
1403 Kenaston Blvd.
Winnipeg, MB R3P 2T5

Tel: (204) 942-4438
Fax: (204) 943-5998
Toll Free: 1-888-204-1234

All Forms

Ottawa forms:

Medical claim form
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
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)
Enrolment form (Health & Pension)
Enrolment form (Health only)
Enrolment form (Pension only)
Change form

Enrolment / Change of Beneficiary Form (Health & Pension)

employee benefits specialists

Personal financial programs for you and your family.

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