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First Nations & Inuit Health

NIHB Client Reimbursement Form

To submit a Client Reimbursement request:

  • Find out about specific criteria or limitations on benefits
  • Contact the Program to verify benefit coverage before making the purchase or receiving the service
  • Fill out the NIHB Client Reimbursement Form online and print it out
  • Sign the form if you are the client (aged 16 or older). A parent or guardian must sign for a child. If you are helping a client aged 16 or older, the client must sign the form. Forms that are not signed cannot be processed.
  • Mail in the completed and signed form along with supporting documents (the claim must be received within one year from the date of service or purchase)
  • Sign up for direct deposit to receive electronic payments, when possible

Have questions or need a printed copy of the NIHB Client Reimbursement Form?
Contact the nearest Regional Office or a local First Nations and Inuit Health Authority.

NIHB Client Reimbursement Form