Green shield dependent 2026

1. Click ‘Get Form’ to open the green shield dependent form in the editor.
2. Begin with Section 1, Employee Information. Fill in your Green Shield ID number, company name, date of birth, first name, surname, address, telephone number, province, city, and postal code.
3. Move to Section 2 for Student Information. Enter the student's name and address along with their Green Shield ID number, province, city, date of birth, and postal code. Don’t forget to include the dependent's SIN number.
4. In Section 3, Mandatory Declaration, indicate if you have other group insurance coverage by selecting 'Yes' or 'No'. If applicable, provide the insurance company's name and attach a statement from the primary carrier.
5. Complete Section 4 by detailing the course program information including the name of the degree/diploma program and its term dates. Specify tuition costs while noting that additional fees are not included.
6. Finally, in Section 5 - Authorization, certify your obligation to pay tuition expenses by signing and dating the form.

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