Policy Extension / Renewal Request
If you wish to extend your stay in Canada and need insurance, please fill out the form below. Our Insurance Advisors will get in touch with you to process your request shortly!
Number of Applicants
First Name
[?]
Last Name
[?]
First Name - 2nd Applicant
[?]
Last Name - 2nd Applicant
[?]
Children/Dependents
[?]
Email
[?]
Phone
[?]
Effective Date
[?]
Expiry Date
[?]
Policy number
[?]

Scroll to Top
Need some help?
Our experienced advisers are just a phone call away!
Do you need advice?
Have questions about your medical coverage options? Feel free to leave us a Call Back request and our insurance advisors will get in touch with you within 1 business day!

You can also leave us a message below, so we can find the most suitable solution to your insurance needs by the time we call you!
Loading...
   
Need some help?
Support Us!
If you like our service, please like us on Facebook !