PRIVATE HEALTH SERVICES PLAN FORMS


For opening a new Brock Health Private Health
Services Plan (PHSP)

1. Enrolment Form


For plans with more than one Covered Employee.

2. Appendix A - Eligible Claimant Information


For making a claim - Pay-As-You-Go plans

3. Manual Claim Form for Pay-As-You-Go plans

4. Spreadsheet Claim Form for Pay-As-You-Go plans


For making a claim - Group plans

5. Manual Claim Form for Group plans

6. Spreadsheet Claim Form for Group plans


Information

7. Introduction Pamphlet - PHSP in Canada



You will need Adobe Acrobat Reader to open these files. If you do not have it installed on your computer, you can download a free copy by clicking