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Portable Life and Portable AD&D

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Downloadable forms

Use this form to update your smoking declaration and apply to receive non-smoking rates on your Portable Life or Portable Accidental Death and Dismemberment (AD&D) insurance.

    To do this, you should:

    • Download and save the correct form, Portable benefits application for non-smoker rates - M4672 (PB177914)
    • Ensure all necessary sections are filled out
    • Mail or email the completed form to Canada Life

    Not the forms you're looking for? Go back to the find a form page.