If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms. If you purchased coverage directly through Canada Life, use our Freedom to Choose™ forms.  

Request an assessment

Use this form to request coverage for a brand name drug.

Step 1: Complete a form.

Download the form and print it, or fill it out in Adobe Reader XI or higher (not your browser) and save. Complete the plan member section.

Step 2: Ask your doctor to complete the physician information section.

Step 3: Submit your form.

You’ll find instructions on how to submit your request on the form itself.