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 - Ottawa

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.
P.O. Box 3517, Station C
Ottawa, ON K1Y 4H5

 

  • Medical claim form (original receipts required, cannot be emailed or faxed)
  • Dental claim form
  • Short term disability claim form (contact the Coughlin Ottawa office for the corresponding forms)
employee benefits specialists
Important forms
Dental - Medical Claim Forms
Dental & medical claim forms
Pre-authorized deposit forms
Pre-authorized deposit forms
Pre-authorized payment forms (Ottawa only)
Pre-authorized payment forms (Ottawa only)
Personal financial programs for you and your family.
What's new
June 29, 2016
Please be advised that a possible labour dispute at Can...
April 12, 2016
Thinking about a career at Coughlin & Associates Lt...
February 24, 2016
Check out the newest Coughlin Courier. (PDF 296 KB)
December 16, 2015
Belfast Road to Coventry Road will reopen on Friday, De...