If you have coverage through an advisor, use our personal insurance forms. If you purchased coverage directly through Canada Life, use our Freedom to Choose™ forms.

Use this form to request an increase to a drug dosage outside of Health Canada’s recommended guidelines. You'll find instructions on how to return the completed form on the form itself. 

Download the form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window (not your browser) and save.