Green shield claim forms 2026

1. Click ‘Get Form’ to open the green shield claim form in the editor.
2. Begin by filling out the 'Patient' section. Enter your surname, first name, birth date, and Green Shield patient number.
3. In the 'Provider' section, input the name of the practitioner, their profession type code (refer to the provided list), and their phone number.
4. Complete the treatment details by specifying the date of last visit covered by provincial plan and any treatment rendered. Indicate if there are other group insurance coverages.
5. Ensure both patient and provider signatures are included at the bottom of the form to certify that all information is accurate.
6. Review all entered information for completeness before submitting your claim within 12 months of service.

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