Get Canada Preventative Health Services Group Application Form 2021-2025

Filling out the Canada Preventative Health Services Group Application Form is an essential step for obtaining liability insurance coverage tailored for professionals in preventative health services. This guide provides a comprehensive, step-by-step approach to completing the form online, ensuring that you provide all necessary information accurately.

Follow the steps to complete your application form online.

1. Click the ‘Get Form’ button to obtain the application form and open it for filling out.
2. Begin with your personal information. Enter your first name, middle initial, and surname in the appropriate fields. Make sure your mailing address, city, province, telephone numbers, and email address are accurately filled out to ensure proper communication.
3. Specify the effective date for which you require coverage. This is crucial as it determines when your insurance begins.
4. Provide your Preventative Health Services Group membership number. Ensure this information is correct as it verifies your eligibility for coverage.
5. Review and select your desired coverage options. Check the mandatory coverage plan and optional coverage plans as per your needs. Be sure to calculate the premiums associated with each option.
6. If applicable, specify the construction type of your building for property coverage. This helps assess any risks associated with your premises.
7. Complete the underwriting questionnaire honestly, detailing your years of experience and whether you require signed waivers from clients.
8. Fill out the warranty questionnaire. Answer the questions regarding any past claims or knowledge of circumstances that could lead to a claim.
9. Review the privacy notice and ensure you understand how your personal information will be used and shared.
10. Finally, sign and date the declaration section, confirming that the information provided is accurate. This section is critical and must be completed for your application to be valid.
11. Once completed, save your changes. You can now download, print, or share the form as needed before submission.

Complete your Canada Preventative Health Services Group Application Form online today to secure your liability insurance coverage.