Formulaire PDF

Option 3 requires no medical questionnaire (guaranteed acceptance). This applies to all FMSQ members.

Option 1 (prescription drug, travel and travel cancellation insurance) and Option 2 (prescription drug, health, travel and travel cancellation insurance) are subject to the insurer receiving and approving the "Insurability Report" form for all medical specialists.

• FMSQ members for over 10 years
• Those who have lost or wish to replace their coverage under a different association plan

The chosen plan is valid for a minimum of two years, and no changes are permitted within that period.

You can e-mail us your completed form at information@sogemec.qc.ca, fax it to us at 514 350-5071, or mail it to our Montreal office. Original documents are required if your plan requires proof of good health (see criteria listed above).