Given the current situation and the possibility of delays in postal services, we encourage you to use our online services.
If you have to send us a paper form, please send it, along with any accompanying information or receipts, via our secure forms submission page rather than by mail.
Instructions
- Fill out and sign the form
- Gather original supporting documents
- Send everything to the address indicated on the form
Important
-
Keep copies of all correspondence for at least 12 months.
- Originals will not be returned.
Forms
Claim for Dental Care Expenses – Plan member – 19110A (PDF, 1.6 MB) Opens in a new window.
This form is used to submit claims for dental care expenses.
Important:
You can also use the claim form that your dentist's office gives you. Be sure to clearly indicate your contract and certificate numbers.
Evidence of Insurability – Dental Care – Plan administrator – 20021A (PDF, 410 KB) Opens in a new window.
This form is used to apply for enrolment in the dental care insurance plan, based on the contract provisions.
Important:
This form is used for dental care only. Use
form 20009A (PDF, 1.5 MB) Opens in a new window. for all other applications for enrolment.