Forms

These forms are available from the HR Service Centre or you can print them here:

Health claim forms:
Health Claim Form [.pdf]
Demande de règlement - Assurance-maladie complémentaire [.pdf]

Dental claim forms:
Dental Claim Form [.pdf]
Demande de règlement - Soins dentaires [.pdf]

Emergency Travel Insurance Brochure

Travel Assistance Brochure [.pdf]
Dépliant - Assistance Voyages Mondiale [.pdf]

Physician's statement / certificat du médecin:

Physician's Statement [.pdf]
Certificat du médecin [.pdf]

Physician's statement - Reduced Parking Permit and Adapted Transport Service:

Physician's Statement for Parking Services or Adapted Transport [.pdf]
Certificat du Médecin - Permis de stationnement réduit ou transport adapté [.pdf]

Educational Assistance Application for Tuition Waiver:

Important: Consult the Educational Assistance Policy before completing the application.Click here.

The application form can be found here

Application for Staff Dependent Tuition Waiver:

Important: Consult the Staff Dependent Tuition Waiver Policy before completing the application. Click here.

Staff Dependent Tuition Waiver [.pdf]
Demande d'exonération des droits de scolarité [.pdf]

Application for optional life insurance:

Evidence of Insurability [.pdf]
Preuves d'assurabilité [.pdf]

Alternate Health Coverage form:

Confirmation of Alternative Health Coverage [.pdf]
Preuve d'une assurance santé complémentaire ailleurs [.pdf]

Application for Health/Dental Coverage for Overage Disabled Dependant Child:

Application for Health/Dental Coverage for Overage Disabled Dependant Child [.pdf]
Demande de couverture pour un enfant handicappé ayant dépassé l'âge limite [.pdf]

Application for Provincial Plan Replacement Coverage:

Application - Provincial Plan Replacement Coverage [.pdf]
Couverture offerte en remplacement du régime provincial [.pdf]

Next: QPIP

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