Get Submit Your Completed Form By - Iris Canada

Navigating the process of completing the Submit Your Completed Form By - IRIS Canada can be straightforward with the right guidance. This guide will provide you with detailed, step-by-step instructions to ensure your form is filled out correctly and efficiently.

Follow the steps to complete the form accurately

1. Click the ‘Get Form’ button to obtain the form and open it in the designated editor.
2. In Part A, print clearly the required information: Provider Name, Provider Number, Clinic Name, and the address, including City/Town, Province, Telephone, Fax, and Postal Code.
3. In Part B, attach a voided cheque, as it is mandatory for processing your request. Mark whether the payment is to be made to the Provider or Clinic by checking the appropriate box. Then, fill in the Transit Number, Bank Number, and Account Number from the voided cheque.
4. In Part C, confirm your authorization by printing your name as Provider and the name of the Clinic. Sign and date the form in the designated areas, indicating the Effective Date.
5. Ensure all necessary signatures are included. Remember that the application will not be processed without the signature of the Provider named above.
6. Once you have filled out the form completely, you can save the changes. You can also download, print, or share the form as needed.

Complete your documents online today to ensure timely processing.