Claim Forms

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Claim Forms

Use these forms to submit a health or dental claim

These forms are in PDF format and can be downloaded to and then printed from your computer with Adobe Acrobat Reader. If you do not have this free software installed on your computer, install it now. Once installed, it can be used to read many documents throughout the Web.

Select the name of the form you require and click to open it, print and complete.
Health Claim Forms
Extended Health Care Claim

Dental Claim Forms
Dental Claim

Out of Province/Out of Canada Health Claim Forms
OOP/OOC Claim

Submit Your Form
Remember to sign the form and attach any necessary receipts. Then submit to your plan administrator, if that's who usually signs your forms. Otherwise, mail your form to the address shown on the form.

For SecureServe Plan Members Only
Access your custom forms by clicking this link.




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