Forms

Please choose and complete the appropriate form below and submit it as per the instructions at the top of the form.

 

New applicants

MyRetiree Plan Application

 

Existing covered members

MyRetiree Plan Change Application

Appointment of Beneficiary(ies)

 

For all other forms, please visit asebp.ca/forms

We’d love to hear from you

Phone

Fax: 780-438-5304
Toll Free: 1-877-431-4786
Allendale Centre East
Suite 301, 6104-104 Street NW
Edmonton, AB T6H 2K7
 
Contact Centre Hours
Sept - June: 7:30 a.m. – 5 p.m.
July - Aug: 8 a.m. – 4:30 p.m.
 
 
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