Get Quikcard Forms

Filling out the Quikcard Forms online is essential for ensuring prompt processing of your vision claim. This guide provides clear instructions on how to accurately complete each section, making it easier for all users to navigate the process confidently.

Follow the steps to successfully fill out the Quikcard Forms online.

1. Click ‘Get Form’ button to access the Quikcard Form and open it in your preferred editor.
2. Start by providing cardholder information. Fill in the group number and card number in the designated fields. Then, enter the cardholder's name, date of birth, address, city, province, and postal code.
3. If the patient is different from the cardholder, enter the patient's information in the corresponding section. This includes their name, date of birth, address, city, province, and postal code.
4. Indicate whether the vision treatment is covered by any other plan by selecting 'Yes' or 'No.' If 'Yes,' provide the name of the insurer.
5. If the payment is to be made to a provider, complete the provider information section. Fill in the license number, provider's name, address, city, province, and postal code.
6. Obtain the signature of the provider or office designate and include the date.
7. List the procedures being claimed by entering the corresponding date of service and fee for each procedure, including exams, glasses, contacts, and low vision services.
8. Read and accept the claimant's statement and authorization. Ensure to check the box confirming the services claimed are medically required if applicable.
9. Finally, enter the confirmation number, provide the cardholder’s signature, and include the date.
10. After completing the form, you can save your changes, download it, print a copy, or share the form as needed.

Complete your Quikcard Forms online today to ensure efficient processing of your claim.