Claims forms

Need a medical or dental claim form?

To download forms, click the appropriate link and follow the instructions.

Ottawa dental and medical claim forms
If our Ottawa office handles your claims, please use these claim forms.

Winnipeg dental and medical claim forms
If our Winnipeg office handles your claims, please use these claim forms.

To find the office responsible for your claims and inquiries, check your plan booklet or contact your employer/plan sponsor.

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)
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Personal financial programs for you and your family.
What's new
March 31, 2020
UPDATE: COVID-19 Coughlin & Associates Ltd. is act...