Forms, forms, forms!

Here's a description of all our PHSP/HSA forms.  Hit the green button links below to get the form you need.  OR, just fill out and sign the Register Online Now and Pre-Authorized Debit Agreement at the very bottom of this page - and we'll get back to you from there!
Use our secure email service to send us any document.  Follow this link

Registration Form
We need this for all plans.  As with any of these forms, call us anytime if you need help.

Appendix A – Eligible Employee(s)
Appendix A is required for all incorporated businesses AND proprietorships with arms-length employees.

Appendix C – Family Members
Appendix C is required for unincorporated businesses only.

Pay-As-You-Go Plan Claim
Just give this claim form to your employer, signed and with receipts, in order to process your claim.

Pre-Authorized Plan Claim
You can send this claim and receipts directly to us, bypassing your employer if you are on a PAD plan.

Direct Deposit Request
By sending us a VOID cheque you agree to the terms of this request form whether you send this form or not.

Pre-Authorized Debit Agreement
This form only needs to be signed and submitted once, and can be cancelled at any time.

Satisfaction Survey
Tell us how we're doing!

Switching to DRA Form
A little helpful form when you're switching to us from another provider.  Remember, if you switch we will waive your registration fee! Register Online Now