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1. Click ‘Get Form’ to open the Medical Expense Claim Form in our editor.
2. Begin by entering your personal information in the 'Plan Member - Insured' section. Fill in your full name, date of birth, and address, ensuring accuracy for effective processing.
3. Indicate your language preference by selecting either English or French. This will help tailor communications regarding your claim.
4. Provide contact details including work and residence telephone numbers. If applicable, include an extension number for easier communication.
5. In the dependants section, list any dependants you are claiming expenses for. Include their names, dates of birth, and relationship to you.
6. For each expense type (Drug Expenses, Vision Care Expenses, Other Expenses), attach original receipts as required and fill in the corresponding costs.
7. Finally, review all entered information for accuracy before signing the form electronically. Ensure you authorize Coughlin & Associates Ltd. to process your claim.

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