Critical Illness Insurance - Application - Canadian Insurance Center

Critical Illness Insurance Form.

Welcome! Please fill out this form to apply for our Critical Illness Insurance. Our team will be in touch with you shortly.

Application - Critical Insurance

First Name

Last Name

What's Your Address?

I agree to be contacted by CICentre about insurance options.

I agree to CIC's Privacy Statement and CASL (Canada's Anti-Spam Legislation).

Our Address: #802-7030 Woodbine Ave, Markham, On, L3R 6G2
Phone Number: 1-866-496-3299
Email: [email protected]

Please fill out the quick form and to continue the process

First Name

Last Name

Phone

Email

Province

By sending the contact form I agree to the Term of Use

Accident Insurance

Critical Illness Insurance

No Medical Life Insurance