Forms

Welcome to Guardian Life’s Preferred Provider Network option (PPO). LifeCare Provisor means Choice and Flexibility.

Forms:

Health Insurance Claim Form. Click here

Online Provider Directory. Click Here for Preferred Providers.

Provider Site Map. Click here

Pre-certification Forms. Medical & Laboratory | Vision | Dental

Provider Network Situation Form. Click here

Future Payment Forms:

• Direct Debit Authorization Form (with Q&A)
• Listbill Request Form
• ​Salary Deduction (Individual Life & Pension)
• Bankers Order - FCB, RBL, RBC & Others
• Bankers Order - FCB, RBL, RBC & Others - USD
• Bankers Order - SCOTIA (with Appendix)
• Single Premium Bankers Order
• Stop Payment Authorization Form
• Online Banking Mandate
• Recurring Credit Card Authorization-USD