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Forms & Documents
Laborers' Health & Welfare Trust Fund of Western Canada
Annual Report to Members Version 2019
Benefit Booklet Version 2019
Change of Address Requisition Version 2.0
Consent to Release Information Version 2.0
Dental Claim Form Version 2.0
Electronic Funds Transfer (EFT) Authorization for Claim Payments Version 2.0
Guide to Applying for Freezing of Hours Version 2.0
Guide to Applying for Weekly Disability Benefits Version 2.0
Health Care Expense Option Claim Form Version 2.0
Home Health - Get to Know Your MFAP Brochure Version 1.0
Home Health - Member and Family Assistance Brochure Version 1.0
Pre-Determination - Hospital Bed Assessment Form Version 2.0
Pre-Determination - Knee Brace Version 2.0
Pre-Determination - Nursing Care Assessment Form Version 2.0
Pre-Determination - Oxygen Concentrator Assessment Form Version 2.0
Pre-Determination - Wheelchair Assessment Form Version 2.0
Prescription Drug Claim Form Version 2.0
Prescription Drug Special Authorization Form Version 2020
Prescription Drug Special Authorization Guidelines Version 2019
Registration/Change Form Version 2.0
Replacement Cheque Declaration Version 2.0
Request for Appeals Version 2.0
Request for Freezing of Hours Version 2.0
Request for Over-Age Dependent Coverage Version 2.0
Retiree Self-Payment Registration Form Version 2.0
Self-Payment Pre-Authorized Debit Agreement Version 2.0
Supplementary Health Claim Form Version 2.0
Vision Claim Form Version 2.0
Weekly Disability Benefits Statement Version 2.0