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Referral Information
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Personal Information
Retirement Date

 

We represent pensioners with the Public Service Health Care Plan Partners Committee and the Pensioners Dental Services Plan Board. To help Federal Retirees representatives better serve you, please let us know if you belong to the:

Membership
Partner Information
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Payment Method
DDS / Cheque Instructions

To complete the join process from monthly pension deduction or by cheque, please download this form, complete it and return it to the address at the bottom of the back of the form.

Credit Card Details  
3-Digit security code usually found on the back of your card.