Manitoba Health

Registration Form

Fill out this form to apply for insured health benefits under the Manitoba Health Services Insurance Plan.  This form must be signed--in person, or prior to mailing to Manitoba Health.

Registration Form in Acrobat PDF format

Notice of Change Form

This form is to be used for reporting the following:
Change of address
Leaving the province
Addition of Dependant/Spouse
Deletion of Dependant

Notice of Change Form in Acrobat PDF format or try the
Fill-and-Print Notice of Change Form (NEW)

Request for Temporary Out-Of-Province Benefits
(For Absences Exceeding Three Months)

Fill out this form if you are going to be temporarily absent from Manitoba for any of the following circumstances:
Vacation   Employment   Education

MS-Word version | PDF version

Application for Out-of-Province Benefits by Persons
Moving Permanently from Manitoba

PDF version

Bilingual

Application for Out-of-Province Health Benefits, Medical (Doctor) Services Out-of-Province Claim Form & Hospital Services Out-of-Province Claim Form

Out-of_Province Claim Forms in Acrobat PDF format

Request for Benefits by Students Attending
Out-of-Province Educational Institutions

Request Form in Acrobat PDF version

Insured Benefits Branch
Manitoba Health
300 Carlton Street
Winnipeg MB  R3B 3M9
CANADA

Phone Numbers:
Voice:  (204) 786-7101
Toll Free:  1-800-392-1207
Fax:  (204) 783-2171
Deaf Access Line TTY/TDD:  (204) 774-8618

Residents within the province from outside Winnipeg:
Deaf Access Line TTY/TDD:
Call the Manitoba Relay Service at 711 or 1-800-432-4444 to reach the above number.

Questions?  E-mail the Insured Benefits Branch

Residents should carry their registration certificate (Manitoba Health card) at all times to present when they or their dependents require health services.