Details | |
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Number | INS5242B |
Title | Medical Certificate for Employment Insurance Family Caregiver Benefits |
Purpose | This form must be completed and signed by a medical doctor or nurse practitioner. To receive Employment Insurance (EI) family caregiver benefits, the claimant must submit this form at the same time as the form INS5257 Authorization to Release Medical Information for Employment Insurance Compassionate Care or Family Caregiver Benefits. |
Group | Employment Insurance |
Important Information Returning the Form |
Forms |
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Service Canada (SC) |
Medical Certificate for Employment Insurance Family Caregiver Benefits PDF: SC-INS5242B, 237 KB, printed on 3 pages (8.5 x 11) |
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