Employer and Employee Forms
For your convenience, MediDirect PDF forms are fillable and savable using the free Adobe Reader, provided you download to your computer prior to use. If you simply click on the Form Name, the linked document will open in your internet browser and functionality is not supported.
Filling and saving PDF forms
- Right mouse click on the form name. Depending on your internet browser, you will choose "save target as" or "save link as".
- Save the PDF fillable/savable form in a folder that you will easily find on your computer.
- Launch Adobe Reader.
- Browse to the folder where you saved the file, and open it from within Adobe Reader. You can now fill and save your PDF form.
- Download claim form
- Sample claim form
- Sample claim form (Ontario employers only)
- Sample claim form (Saskatchewan employers only)
Prefunded Claim Form (Companies with special arrangements)
If you are unsure which claim form to use, please call us toll free
1-866-234-5162 or in Calgary at (403) 537-6298
- Add or Delete Employee(s)
- Related Form: New employees must complete an "Employee Personal Information and Authorization"form
Change Employee Benefit Levels
Company-Wide or for Individual Employees
Change your Health Spending Account Levels for any or all classifications of employees, or change a classification for an individual employee
- Related Form: Changes in marital or dependent status that affect an employee’s benefit level require inclusion of "Employee Change Personal Information" form
Employee Personal Information and Authorization
For new employees who are eligible to participate in the program
Change Employee Personal Information and Authorization
For existing employees who wish to change their name, contact information, marital status, or dependent information
- Related Form: Changes in marital or dependent status that affect your benefit level require inclusion of "Employer Change Employee Benefit Level and Classification" form