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 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 races questionnaire
• [4100-521] Questionnaire about epilepsy
• [4100-522] Sport Questionnaire
• [4100-523] Sleep Apnea Questionnaire
• [4100-520] Questionnaire about climbing

Authorization forms

• [4300-123] Authorization for disclosure of information Personnal record
• 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 release 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)

Banking informations

• [4100-127] Pre-Authorized credit card agreement
• [4100-018] Pre-authorized debit agreement
• [4300-054] Direct Deposit

Others

• [4100-011] Irrevocable Beneficiary Designation (For Nova Scotia)
• [4100-020] Assignment of the contract
• [4100-022] Notice of change of address
• 4100-038] Request for cash surrender value
• [4100-039] Re-Assignment
• [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] Beneficiary Designation
• [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)

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
• [4400-082] Prodige - Dépliant (french only)
• [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

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