Forms

  • Emergency Out of Province/Out of Country Claim Form (ABC 30741)
    Use this form to submit emergency medical expenses incurred while travelling. These could include expenses such as the following: ambulance, hospital, airfare and vehicle return.
  • Travel Refund Request form (ABC 31403)
    Use this form to request a refund for the previously submitted travel request. Visit our FAQ page for more information about refunds.
  • Consent to Release Medical Information (ABC 30225)
    This form is intended for Out of Province/Out of Country claimants who have purchased an individual travel plan and should only be used if you are hospitalized or require emergency medical treatment while travelling. Please complete the form and fax it to Alberta Blue Cross. By signing this form, you give your permission for Alberta Blue Cross to obtain medical information from your Canadian physician or clinic to identify any relevant pre-existing medical conditions and to process your claim.
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Where to next?

Find out who to contact in the event of an emergency.

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