You can fill out any form online or download the PDFs. Please send forms directly to Groupe Premier Médical and attach any receipts. If your office has a claim box, please attach your receipts to the appropriate form.
Plan member
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- Beneficiary Modification Form
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- Consent to change of Irrevocable Beneficiary
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- Dental Claim Form
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- Medical Claim Form
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- Short Term Disability Claim Form
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- Direct Deposit Authorization
Plan administrator
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- Enrolment form
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- Modification form A
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- Modification form B
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- Short Term Disability Claim (Employers)
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- Direct Deposit Authorization
Health service provider
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- Short Term Disability Claim - Psychological Illnesses
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- Short Term Disability Claim - Physical Illnesses
