Out of Province Claim for Physician Services
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Forms, Links, and Information
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English - 014-0000-80e - Out of Province Claim for Physician ServicesPDF
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French - 014-0000-80f - Out of Province Claim for Physician ServicesPDF
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English - 014-0000-80e - Out of Province Claim for Physician ServicesHTML
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French - 014-0000-80f - Out of Province Claim for Physician ServicesHTML
Additional Information
| Form Number | 014-0000-80 |
|---|---|
| Title | Out of Province Claim for Physician Services |
| Description | Under Interprovincial agreement, for travel within Canada, patients/physicians submit form to get reimbursed by applicable health plan. |