Minto & Wilkie Insurance Forms
Each of the insurance forms listed below are for your convenience. They are in PDF file format and will open another browser window. All forms may be printed for your personal use.

• Individual Change of Coverage Application
• Individual Member Claim Form
• Individual Prescription Drug Claim Form
• Individual Authorization for Use of Protected Health Information

• Individual Subscriber’s Statement of Claim
• Individual Subscriber IFP Plan Change Request Form