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NATIONAL CLAIM FORM MEMBER INFORMATION ID Number: Policy Number: Provincial Health Plan No. (applies only to BC and SK residents): Date of Birth (DD/MM/YYYY): Last Name: First Name: Address: City:.

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  1. Find the document template you will need in the collection of legal forms.
  2. Choose the Get form button to open the document and begin editing.
  3. Submit all the required boxes (they will be yellowish).
  4. The Signature Wizard will help you insert your electronic autograph as soon as you have finished imputing information.
  5. Put the date.
  6. Double-check the whole document to ensure you have completed all the information and no corrections are needed.
  7. Click Done and download the resulting template to the gadget.

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