Member Appeal Form Submission

You have the right to tell us when you disagree with a decision we have made. If you want to appeal a decision notice on your services or an appeal of a complaint/grievance resolutiuon or claim decision, please complete this form.This form is a safe way to request an appeal online and attach any information you'd like us to review. If you have follow-up questions, please call Trillium at 1-877-685-2415 and ask to speak with an Appeals Coordinator.

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