AUTHORIZATION FORM FOR POST-CATARACT SURGERY …
THE COST, IF ANY, OF OBTAINING THIS INFORMATION IS AT THE EXPENSE OF THE PATIENT/PLAN MEMBER. ... to Green Shield Canada about myself and my dependents, will be used by Green Shield Canada for claims adjudication and any other services necessary in the administration ... Authorization Form for Post Cataract Surgery & Eyewear EN (Rev. 2015-01 ... ................
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