Forms

Insurance Forms

Here you’ll find a consolidated list of all insurance forms for members.

Please note that some of these forms are fillable PDFs which are only compatible with Google Chrome or Internet Explorer browsers. 

Life, Disability, Accident & Illness

• Application Form
• PDI Application
• AD&D Beneficiary Designation 
• AD&D Insurance Application
• Direct Debit form
• How to pay your premium

Health & Dental

• Application Form - Member Agreement
• Enrollment Form 
• Request for Change
• Termination of Coverage 
• Dental Claim Form (Canada Life)
• Health Claim Form (Canada Life)
• Cost-Plus Claims Guide
• Cost-Plus Claim Form
• Sole Proprietor 

Resident Forms

• Resident Life Application without proof of good health
• Resident Transition to Practice Options Form - within 90 days of completing residency/fellowship
• Resident Disability Application (Without Proof of Good Health)
• Resident Disability Application (With Proof of Good Health)

Student Forms

• Student Insurance Application
• Student Disability - 4th Year $4,000 Option Form
• Student Transitioning to Resident Form
• 1st Year Student Membership and Insurance Application