Dental Claim Form

The Pacific Blue Cross dental claim form is available from the link below. Please remember to attach your reciept if the dental service provider has not signed the claim form.

Download Dental Claim Form

Please note:

Click here for more information on how to submit a dental claim.
Click here for information on how to submit orthodontic claims.
Dental claim forms are also available from your dental service provider.
Providers, RCMP and Canadian Forces members looking for claim forms click here.
Our forms allow you to save your personal information. You can protect your information by saving this form to a secure location. Pacific Blue Cross and/or BC Life are not responsible for information saved in locations beyond our computer system.

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