Get Ins5216

Filling out the Ins5216 form online is an essential step for accessing Employment Insurance Compassionate Care Benefits for family members of those who are seriously ill. This guide provides clear instructions to help you complete each section of the form accurately and efficiently.

Follow the steps to complete the Ins5216 form online.

1. Press the ‘Get Form’ button to obtain the Ins5216 form and open it in your preferred online editor.
2. Begin with Section 1, which requires patient information. You need to enter the family name, date of birth, all given names of the ill family member, and their residential address. Be sure to include the apartment number, street number, city, province, country, and postal code if applicable.
3. In Section 1, there is also an authorization statement. Ensure that the individual authorized to release medical information signs and dates this section.
4. If the patient cannot complete Section 1, move to Section 2. This must be completed by the patient's legally authorized representative. Provide their name, telephone number, and relationship to the patient. The representative must sign and date this section as well.
5. Proceed to Section 3, which is to be completed by a doctor or medical practitioner. The doctor must provide the date of their last examination of the patient and certify the patient's medical condition in relation to the compassionate care benefits.
6. In Section 3, the doctor must answer specific questions regarding the patient's condition and needs for care. They will also confirm whether the patient can give consent or not.
7. Ensure that the doctor provides their contact information, including specialty, license number, address, and phone number in Section 3.
8. After completing all sections, review the form for accuracy. Once you're satisfied with the information, you can save changes, download a copy, print it, or share the form as needed.

Start filling out your Ins5216 form online today to access the compassionate care benefits you may be entitled to.