Important instructions to read before you start the registration

This form includes questions about your diagnosis of smoking-related illness and your smoking history.

Once you have started the form, you must submit it for your answers to be saved. Please note that some fields are mandatory in order to submit the form.

If you start the form, but do not submit it, you will have to restart your registration from the beginning. In other words, once you’ve started, you must submit the form for your answers to be saved. Following an attempted registration, you will not be able to restart the form for a period of 48 hours.

It is therefore important to have all the information you need to fill in the form correctly. In your case, all you need is:

• an approximation of the date you received your diagnosis(es), to the best of your knowledge;
• your smoking history from 1950 to 1998, to the best of your knowledge.

You do not have to provide proof of your diagnosis to make a claim. In fact, the Québec Administration Plan provides that information on class members’ diagnoses will be obtained by the lawyers from the Québec Cancer Registry or MED-ECHO. You will only be asked for proof if your diagnosis cannot be confirmed by these registries. This is unlikely to be necessary.

However, if you already have medical records or a note from a doctor, you can send us these documents. We ask that you submit your documents at the end of this form, if possible. It would be best to have collected and scanned all the documents you wish to send us before starting to fill in the form.

However, if you do not have everything in hand, you can submit them via our secure submission platform on our website. In order to submit documents via the secure submission platform, you will need to provide your file number (CAS-12345-123ABC), which will be given to you once you have submitted your form. So, if you have answered all the questions but are missing one or two documents, it would be easier for you to submit the form and send us the documents as soon as you have them. It is best if you complete your registration to avoid losing all the answers you have filled in.