Get Ins5223

Filling out the Ins5223 form accurately is crucial for obtaining compassionate care benefits. This guide will help you navigate the online process step-by-step, ensuring you provide all necessary information.

Follow the steps to complete the Ins5223 form effectively.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by filling out Section 1A, which requires the patient's information. Enter the family name and all given names of the patient. Make sure to include the residential address, including apartment number, street name, province or territory, city or town, country, and postal code if the patient is in Canada.
3. If the patient cannot sign the attestation, move to Section 1B. This section must be completed by a legally authorized representative. Indicate that you are authorized to act on behalf of the patient and confirm that they are unable to sign.
4. Print the name of the patient's representative and include their telephone number with the area code in Section 1B.
5. Next, proceed to Section 2, the attestation section. Here, the claimant's name must be written alongside the name of the patient or representative. Confirm the relationship, acknowledging that the claimant is considered like a family member for the purposes of EI Compassionate Care Benefits.
6. Both the patient or representative and the claimant must provide their respective signatures and dates in this section to finalize the attestation.
7. Once all sections are complete, ensure you review the form for accuracy. You can then save your changes, download a copy for your records, print it out, or share it as necessary.

Complete your Ins5223 form online today to apply for compassionate care benefits.