![](https://www.pdfsearch.io/img/57cc0642a4d3c9a88f8f3df3209b1710.jpg) Date: 2016-01-11 09:42:51
| | SPECIAL AUTHORIZATION REQUEST Standard Form Fax Requests toOR Mail Requests to Clinical Services, ClaimSecure Inc., Suite 620, 1 City Centre Drive, Mississauga, Ontario, L5B 1M2 OR Email Special.AuthorizatiAdd to Reading ListSource URL: www.aeplan.caDownload Document from Source Website File Size: 227,39 KBShare Document on Facebook
|