Employee Benefits Claim Forms

	Authorization Form for Custom Braces		Dental Pre-Treatment Form
	Claim Form for Custom Foot Orthotics		EHS Claim Submission Form
	Claim Form for the Services of an RN, RNA, RPN, PNA, LPN, Personal Support Worker		General Claim Submission Form
	Drug Claim Submission Form		Dental Care Claim
	EHS Claim Submission Form		Vision Care Claim

Please send completed forms to Green Shield Canada.
All address information can be found on the claim form.

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