| Details | |
|---|---|
| Number | INS5242A |
| Title | Authorization to Release a Medical Certificate for Employment Insurance Family Caregiver Benefits |
| Purpose | INS5242A: This form will be used to process claims for the Employment Insurance (EI) Family Caregiver benefit. The Authorization to Release a Medical Certificate for Employment Insurance Family Caregiver Benefits must be submitted by the EI claimant, along with the Medical Certificate for Employment Insurance Family Caregiver benefits, in order to access the Family Caregiver benefit. This form must be shown to the medical doctor or nurse practitioner who completes and signs the Medical Certificate for Employment Insurance Family Caregiver benefits. INS5242B:This form will be used to process claims for the Employment Insurance (EI) Family Caregiver benefit. The Medical Certificate for Employment Insurance Family Caregiver benefits must be submitted by the EI claimant in order to access the Family Caregiver benefit. The Medical Certificate must be completed and signed by a medical doctor or nurse practitioner. |
| Group | Employment Insurance |
|
Important Information Returning the Form | |
| Forms |
|---|
|
This site uses PDF form technology. To print these high-quality PDF forms, you must have a PDF reader installed. If you do not already have such a reader, there are several available on the Internet :
Adobe Reader
and Foxit Reader The form(s) are available in the following formats.
|
| Service Canada (SC) |
|
Authorization to Release a Medical Certificate for Employment Insurance Family Caregiver Benefits PDF: SC-INS5242A, 112 KB, printed on 1 pages (8.5 x 11) |
For more information, please consult the Forms Help page.