Uniformed Fire Officers Assocation

Family Protection Plan Forms

Go to Forms for Active Officers
Go to Forms for Retired Officers
Applications for Catastrophic Insurance
GHI Student Verification Form

Important!
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Forms for Active Officers

Optical Certificate and Instructions
After filling out the optical form, mail it to the Family Protection Plan.
You will receive a validated Optical Card which you fill out and take to your eye doctor.
Dental Expense Benefit Claim Form
Instructions for Dental Expense Claim Form
Hearing Aid Benefit

Forms for Retired Officers

Optical Certificate and Instructions (Retired Officers)
After filling out the optical form, mail it to the Family Protection Plan.
You will receive a validated Optical Card which you fill out and take to your eye doctor.
Dental Expense Benefit Claim Form (Retired Officers)
Instructions for Dental Expense Claim Form (Retired Officers)
Hearing Aid Benefit

Catastrophic Major Medical Forms

Plan Description
Application
Claim Form

GHI Student Verification Form

Student Verification Parent Affidavit Form

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