Manitoba Health
To view PDF files, you must have a copy of the Adobe Acrobat Reader which is available as a free download.
Manitoba Health Forms
Please read the Disclaimer and Privacy Statement below which applies to all Manitoba Health forms.
NEW! Online eNotice of Change Form
Try Manitoba Health's new online eNotice of Change Form if you are making changes to your health card. This online form is for the purpose of notifying Manitoba Health of your:
- Need for a replacement Health card
- Need to change your address on your Health card
- Permanent move outside of the Province of Manitoba
- Need to delete a spouse from your Health card due to divorce / separation
- Need to move a minor dependant(s) to another Health card
- Need to report a death
CLICK HERE to open the online eNotice of Change Form
NOTE: Based on the language settings of your computer, you may get error messages. The form is still functional, however you can also access the printable version.
Other Manitoba Health Forms
To make any other changes that are not listed above to your Manitoba Health card or to register for Manitoba Health coverage or for requests for continued health coverage for residents who will be temporarily outside of the province, please view other available forms below.
- Registration for Health Coverage Form
- Notice of Change Form
- Print and Fill Later version
- Fill Online and Print version
- Request for Temporary Out-of-Province Benefits
(For Absences Exceeding 3 Months for Vacations, Sabbaticals and Humanitarian Aid Workers)
- Request for Benefits by Students Attending
Out-of-Province Educational Institutions
- Application for Out-of-Province Benefits by Persons
Moving Permanently from Manitoba
(Health coverage will continue for the remainder of the month in which you move, plus two months)
- Application for Out-of-Province Health Benefits / Out-of-Province Claim Medical (Doctor) Services / Out-of-Province Claim Hospital Services
Disclaimer
The purpose for which this information is being collected is to enable Manitoba Health to provide you with health coverage and/or service. If you require any further information about the collection of this information, please do not hesitate to contact a Manitoba Health representative at 786-7101 (toll free: 1-800-392-1207).
If you move to Manitoba from another province or territory in Canada, you may receive health care benefits (except personal care home benefits) from the first day of the third month after arrival. Until then you should maintain coverage with the health insurance plan of your previous home province or territory.
If you move to Manitoba from another country, you may receive health care benefits (except personal care home benefits) from the first day of your arrival provided you have the appropriate documentation, i.e., permanent resident status, proof of Canadian Citizenship if Returning Canadian, et cetera.
Eligibility for coverage is subject to The Health Services Insurance Act and Regulations.
Privacy Statement
The personal information you may be asked to provide is being collected under the authority of legislation and/or program policies under the jurisdiction of the Minister of Health. The information is required to provide health coverage and/or service and is protected under the protection and privacy provisions of The Freedom of Information and Protection of Privacy Act as well as The Personal Health Information Act. If you have any questions about the collection of personal information, please contact: Access and Privacy Coordinator, Manitoba Health, 1st Floor Carlton Street, phone 204-786-7237.
| For more information: |
Residents within the province
from outside Winnipeg:
Residents should carry their registration certificate (Manitoba Health card) at all times to present when they or their dependents require health services. |
