The standard hospital form is available directly from this site in either English or French. Please download the appropriate form by clicking on the links below.

The Hospital Claim Payment Standards adopted by the CLHIA are available to assist hospital administrators in the completion of these forms.

• Claim Form for Hospital Expenses
  
  
• Hospital Claim Payment Standards
  
  
• Demande de règlement des frais d'hospitalisation
  
  
• Normes concernant le règlement des frais d'hospitalisation
  
  

If further assistance is required, please submit an inquiry.