Active Members  |  Forms

Medical Cannabis Prior Authorization Form

Coverage Details

Description

Complete this Prior-Authorization form prior to claiming for medicinal cannabis.

Applicable for

Member / Spouse / Dependents

Submit your form online:

Step 1

Download, print and fill out the form.

Download Form
Step 2

Upload the form using our online submission form.

Upload Now

Submit by mail:

LiUNAcare Local 183
200 Labourers Way
Vaughan, ON, L4H 5H9
Suite 2100

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