Retired Members | Forms

Speech Therapy Medical Questionnaire

Coverage Details

Description

Physician to complete the Speech Therapy Medical Questionnaire for dependent children prior to incurring speech therapy claims. Benefit available to dependent children only.

Applicable for

Dependent Children

Related Benefits

Submit your questionnaire online:

Step 1

Download, print and fill out the questionnaire.

Download Questionnaire

Step 2

Upload the questionnaire using our online submission form.

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Submit by mail:

LiUNAcare Local 183
200 Labourers Way
Vaughan, ON, L4H 5H9

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Speech Therapy Medical Questionnaire

Coverage Details

Submit your questionnaire online:

Submit by mail:

Get Mobile Access to Your Benefits

Check Out Our Mobile Apps

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Speech Therapy Medical Questionnaire

Coverage Details

Submit your questionnaire online:

Submit by mail:

Get Mobile Access to Your Benefits

Check Out Our Mobile Apps

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