Ins5216a 2025

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The document is an Authorization to Release a Medical Certificate for Employment Insurance Compassionate Care Benefits, which must be completed by the patient or their legally authorized representative. It outlines the process for obtaining compassionate care benefits for family members of seriously ill individuals, including the collection and use of personal information by Employment and Social Development Canada (ESDC). The document emphasizes the importance of submitting both the authorization form and the medical certificate together, as well as details regarding fees and patient consent.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (40 Votes)
2012	4 Satisfied (23 Votes)

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