Out of Province Claim Forms

Out of Province claims processes hospital reciprocal payments to other provinces for BC Residents attending hospitals outside BC, as well as Non-Residents obtaining services in a BC hospital.  The forms below are to assist in these transactions.

Form # Form Name and Information


This form is to be completed by a physician applying for funding for a patient requiring out of province mental health or addictions inpatient stay in a facility outside the province.  These services are outside the Reciprocal Billing Agreement.


This form is required for residents and non-residents requiring inpatient hospital stays in British Columbia and other provinces as per the Reciprocal Billing Agreement. This form is to be completed by the hospitals of British Columbia on behalf of the patients.