GP Business Partner Updates

* required  
Are you a Clinic  Physician *
Do you or have you billed ICBC via MSP-Teleplan?
Yes No *
Does your clinic offer any of the below services?Yes No *
Acupuncturists
Chiropractors
Counsellors
Kinesiologists
Occupational therapists
Physiotherapists
Psychologists
Have you previously provided service to ICBC and know your account?
Yes No *
Do you need to make any updates to the following? *
(one or more must be chosen)
Vendor Information
Address
Tax Information
General Information
Payment Method

Vendor Information

May start with a letterhelp text Existing Account Number *
Legal Name *

Address

Address *
City *
Postal Code *
Country
PO Box

Tax Information

GST Number *

General Information

Does your company gross over $30,000K per Fiscal year?
Yes No *

Payment Method

How do you want to be paid *
Cheque - Payment and Statement sent via Canada Post
EFT - Payment and Statement sent electronically
Email for statement *












Email for reply to this submission *