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Get Form 5945/5946 2005-2024

RTS 1 AND 2) AND FORM 5946 (PARTS 1, 2 AND 3). Instructions to Claimant (Form 5945 – attached) Please complete and sign Part 1 of the attached form. Also complete and sign the authorization at the beginning of Part 2. Then forward the form to the attending physician. Once the entire form has been completed it should be sent directly to Industrial Alliance at the address below, at least two months prior to the date you expect your benefits to become payable, if the claim is approved. Group Dis.

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