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
175 Hargrave Street, Suite 100
Winnipeg, MB R3C 3R8

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

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

 

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Important forms
Dental & medical claim forms
Ottawa | Winnipeg
Pre-authorized deposit forms
Ottawa | Winnipeg
Pre-authorized payment forms (Ottawa only)
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What's new
February 17, 2010
Read the Coughlin Courier.
January 01, 2010
Effective January 1, 2010, Health Canada will require certai...