Claims forms - Winnipeg

Click to download the appropriate form in .pdf format

Print, complete and sign the form. Return it, and all receipts, to Coughlin & Associates Ltd. at:

Coughlin & Associates Ltd.
Box 764
Winnipeg, MB R3C 2L4

• Medical claim form (original receipts required, cannot be emailed or faxed)
• Dental claim form
• Short term disability claim form (this form is for clients from the Winnipeg office only)