Obtain a Form

Medical or Lifestyle Questionnaires

• [4100-500] Tobacco Use Questionnaire
• [4100-501] Gastrointestinal Disorder Questionnaire
• [4100-502] Diabetes Questionnaire
• [4100-503] Back Pain Questionnaire
• [4100-504] Alcohol Use Questionnaire
• [4100-505] Musculoskeletal Disorders Questionnaire
• [4100-506] Respiratory Disorder Questionnaire
• [4100-507] Loss of Consciousness Questionnaire
• [4100-508] Concussion, Skull Fracture, and Head Injury Questionnaire
• [4100-509] Aviation Questionnaire
• [4100-510] Racing Questionnaire
• [4100-511] Foreign Travel Questionnaire
• [4100-512] Automobile Driving Questionnaire
• [4100-513] Drug Use Questionnaire
• [4100-514] Nervous Disorder Questionnaire
• [4100-515] Chest Pain Questionnaire
• [4100-516] Skydiving and Hand Gliding Questionnaire
• [4100-517] Scuba Diving Questionnaire
• [4100-518] Snowmobile Racing Questionnaire
• [4100-521] Epilepsy Questionnaire
• [4100-522] Sports Questionnaire
• [4100-523] Sleep Apnea Questionnaire
• [4100-520] Outdoor and Indoor Climbing Questionnaire

Authorization Forms

• Ontario - Third Party Request For Personal Information
• [4300-126] British Columbia - Authorization for DisClosure of Information Personnal Record
• Ministry of Health and Long-Term Care Request for Access to Personal Information
• [4300-118] Authorization to Release Information Concerning a Deceased Insured Person
• [4300-119] Authorization for Disclosure of Information Personnal Record
• [4300-013] Authorization
• [4300-018] Authorization in the Event of Death
• [4100-061] Authorization to Collect Personal Information
• [4300-123] Authorization for Disclosure of Information (Alberta)
• [4300-119] Authorization for Disclosure of Information (New Brunswick)
• Authorization for Disclosure of Information (Newfoundland and Labrador)
• Authorization for Disclosure of Information (Nova Scotia)
• Authorization for Disclosure of Information (Quebec) Form 2811 (French Only)
• Authorization for Disclosure of Information (Quebec) Form 2836 (French Only)
• Authorization for Disclosure of Information (Saskatchewan)
• [4100-067] Change of Email

Banking Informations

• [4100-127] Pre-Authorized Credit Card Agreement
• [4100-018] Pre-Authorized Debit (PAD) Agreement
• [4300-054] Direct Deposit

Others

• [4100-011] Policy Cancellation Request
• [4100-020] Assignment of Contract
• [4100-022] Change of Address
• [4100-038] Request for Cash Surrender Value
• [4100-039] Reassignment of Contract
• [4100-519] Financial Questionnaire
• [4300-001] Notice of Return to Work
• [4300-008] Claim Form in Case of Dismemberment or Total Loss of Use
• [4300-021] Psychological Illnesses Additional Report
• [4300-021] Physical Illnesses Additional Report
• [4300-025] Overhead Expenses Claim Form Insurance Select Plus/Paie
• [4300-044] Critical Illness Physician's Statement (Heart Attack)
• [4300-046] Critical Illness Physician's Statement (Coronary Artery Bypass Surgery)
• [4300-047] Critical Illness Insurance Confidential Physician’s Report (Cancer)
• [4300-048] Critical Illness Physician's Statement (Stroke)
• [4300-059] Subrogated Policy Owner Designation
• [4300-060] Critical Illness Physician's Statement (Multiple Sclerosis)
• [4300-061] Critical Illness Physician's Statement (Autism)
• [4300-066] Critical Illness Physician's Statement (Deafness)
• [4300-030] Critical Illness Child Insurance - Initial Statement
• [4100-019] Application of a New Policyowner
• [4100-009] Change of Beneficary
• [4100-045] Declaration of Insurability
• [4100-064] Declaration of Insurability for Prohealth Income Insurance - Accident
• [4100-053] Disability, Life and Critical Illness Change Application
• [4300-031] Compassionate Leave Benefit - Critical Illness
• [4300-033] Disability Claim Form - Initial Assessment
• [4300-035] Statement in the Event of Dismemberment
• [4300-045] Claim Form for Critical Illness Insurance Benefit Proof of Claim - Claimant’s Statement
• [4300-012] Claimant’s Statement
• [4300-016] Proof of Death - Physician Statement
• [4100-04]2 Redating Request
• [4300-083] Claim Form Medical and Paramedical Fees
• [4100-052] Determination of Persons
• [4300-084] Dental Claim Form
• [6050-032] Change of Service Representative
• [4100-066] Declaration of Insurability for Insurance Without Medical Exam (DBS ASSEM)
• [4100-065] Irrevocable Beneficiary Designation (for Nova-Scotia)

Product Documentation

• [4400-009] Insurance Without Medical Exam - Flyer
• [4400-022] Term Critical Illness Insurance
• [4400-034] IWME - Product Guide
• [4400-046] Children360 - Product Guide
• [4400-063] Critical Illness - Insurance Without Medical Exam - Flyer
• [4400-072] Preselection Guide - Accident Illness
• [4400-092] Prodige - Brochure
• [4400-083] HuGO Life - Product Guide
• [4400-085] HuGO Preselection Guide
• [6050-049] Children360 Insurance - Horizontal Flyer
• [6050-113] HuGO Insurance - Horizontal Flyer
• [4400-167] AMG - Product Guide
• [4400-029] Flyer / Application Form - Street-Wise
• [6050-118] Teladoc Medical Experts Flyer

Insured (Member of a Group)

• [4200-002] Statement of Marital Status
• [4200-021] Designation or Change of Beneficiaries
• [6050-289] Insurance Conversion Guide
• [4100-126] Insurance Conversion Application

Group Administrator (Manager)

• [4200-027] Notification of Change
• [4200-058] PDF Booklet Request Form
• [4200-042] Plan Administrator Designation Form
• [4200-032] Declaration of Insurability
• [4400-015] Fracture Benefit Brochure
• [4200-018] Pre-Authorized Debit Agreement
• [4200-038] Group Insurance Application

Protections and Services

• [6050-289] Insurance Conversion Guide
• Compassionate Care Leave Brochure
• [6050-234] Compassionate Care Leave Guide
• PreZen+ Brochure
• [6050-194] Roadside Assistance Brochure
• [6050-084] Health & Dental Spending Budget Brochure
• [6050-327] Travel Assistance and Trip Cancellation Insurance Brochure

Products Without Advisor

• EIRM-60100 Certificate Humania
• EIRM-60100 Group Policy Humania
• EIRM-60120 Certificate Humania
• EIRM-60120 Group Policy Humania
• EIRM-60140 Certificate Humania
• EIRM-60140 Group Policy Humania
• Kaleido-20191021 Certificate Humania
• Kaleido-20191021 Summaries Humania

• [3200-037] Order Form Flyer
• [6050-259] Multiple Policy and Family Discount
• [6050-208] Innovative Web Solutions
• [6050-216] Compliance Survey
• [4100-056] Application Disability, Life and Critical Illness Insurance

Various

• [2050-007] Claimant's Charter of Rights and Responsibilities
• Complaint Examination Policy
• [4100-139] Group Association Insurance Application | Health Declaration
• [4400-066] Financial Needs Analysis - Life Insurance
• [2050-006] Complaint Form
• [2200-002] Incident or Non-Compliance Investigation Report