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Results for Forms (11)

AUTHORIZATION FORM FOR PROSTHETIC APPLIANCES AND DURABLE MEDICAL EQUIPMENT c ______/______/______ Yes PO Box 1623, Windsor, Ontario N9A 7B3 Attn: EHS Department Customer Service Centre 1-888-711-1119

GENERAL CLAIM SUBMISSION FORM (For Drug and Extended Health Claims) *NO STAPLES PLEASE, PAPER CLIPS ONLY GENERAL CLAIM SUBMISSION FORM (For Drug and Extended Health Claims) SECTION 1 - PLAN MEMBER

It's super easy! Just follow these steps.   Visit the website providerConnect.ca by clicking here Use the dropdown box to select whether you want to view drugs by their generic names or brand names.

HEALTH CARE SPENDING ACCOUNT CLAIM SUBMISSION FORM HEALTH CARE SPENDING ACCOUNT CLAIM SUBMISSION FORM This form should be used when claiming reimbursement under your Health Care Spending Account,

AUTHORIZATION FORM FOR GLUCOSE MONITORING SYSTEM _____________________________________ ____________________________________ AUTHORIZATION FORM FOR GLUCOSE MONITORING SYSTEM PO Box 1623, Windsor,