The forms on this page are for the exclusive use of health professionals who do not have an address in Québec.
The SAAQ offers the reimbursement of psychoeducation services that are covered and given by psychoeducators to accident victims. The SAAQ asks that you claim a reimbursement for psychoeducation services at the end of the authorized block of hours, using the form for that purpose.
This form is available as a dynamic PDF. You may:
Authorization to Reimburse Service Providers Directly for Professional Services to be Rendered (PDF, 108.5 ko)
1 page (4099A 30)
This form allows accident victims to authorize the SAAQ to directly reimburse the professional services provider.
This document was developed as a visual aid for program participants during your appointments. For example, you can project it on your screen. It is not necessary to give the participant a printed copy, unless you believe it necessary in order to present specific content.
Last update: October 27, 2021