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I Need a Form

Important
 

  • Any form identified as an "E-form" can be completed electronically.  Please read the instructions carefully, print the form, sign it and return it with any required documentation.

 

  • When you print the forms, please make sure that the print quality of the document is good and follow the instructions provided.

 

  • You will need to download Adobe Reader to view and print the selected document. To download the software free of charge, simply click below.

    Download Adobe Reader
     

 

Claim Forms

To submit a claim for coverage included under your group insurance plan, namely:
 

  • Drugs and other health care expenses
  • Dental care expenses
  • Disability benefits
  • Travel insurance expenses
     

In order to find the appropriate form, select one of the following options according to your province of residence.

Province of Quebec

Canadian provinces and territories with the exception of Quebec


 

Administrative Forms

To ensure good management of your group insurance plan, you will find in this section the administrative forms that you need to inform us of your changes.

The appropriate forms are determined by the administrative centre that manages your contract, the address of which is noted as the return address of this office.

Select your administrative centre below to find the appropriate form.

Administration - Levis

Administration - Toronto

 

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  • Call 1-866-838-7553 (8 a.m. to 5 p.m. Eastern time, Monday to Friday).

Link - For Healthier Employees
 
 
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Copyright © 2008 Desjardins Financial Security. All rights reserved.