Name Change
If you change your name, you are required to report the change to Manitoba Health to remain eligible for coverage.
To report a name change, follow these three steps:
1.
Gather the required documents
You will need to provide additional documents along with the completed form.
You must submit a copy of one of the following documents:
Marriage certificate
A document issued by a provincial/territorial Department of Vital Statistics Branch (or other jurisdiction) which confirms a marriage. It may be used to merge two Manitoba Health registration cards to a family-style registration card, and can also be used to assume a married surname on a Manitoba Health card.
Divorce certificate
A document issued by a provincial/territorial court (or other jurisdiction) which confirms that a divorce has been finalized and that the parties named are free to re-marry. It is used as proof of a family separation, and also as proof that a person may legally re-assume a maiden surname if they were previously using their spouse’s surname during the marriage.
Legal name change document
A single-page document issued by a provincial/territorial Department of Vital Statistics branch. This document can be used to change the name on a Manitoba Health card.
2.
Complete the form
The form can only be filled out by the cardholder.
You will need your Health Card Registration Number and Personal Health Identification Number (PHIN).
You can see where these numbers are located on your Manitoba Health Card here.
If you do not have your health card information available, please contact 204-786-7101 or 1-800-392-1207 (toll free).
When you are ready, complete the following form:
Name Change Form - Manitoba Health (PDF)3.
Submit
To submit your request, send the completed form and copies of the required documents to one of the following:
Email:
insuredben@gov.mb.ca
OR
Mail or drop off:
Registration and Client Services Unit
Manitoba Health
300 Carlton Street
Winnipeg, Manitoba R3B 3M9
Business hours: Monday to Friday, 8:30am to 4:30pm
OR
Fax: 204-783-2171 or Toll Free: 1-866-608-2983
Need help?
Public Access Computers are available at the following locations:
Winnipeg
Registration and Client Services
Manitoba Health
300 Carlton Street
Winnipeg, Manitoba R3B 3M9
Business hours: Monday to Friday 8:30 to 4:30
Bilingual Service Centre
Main floor, 170 Goulet St, Winnipeg MB
Rural areas
Contact the city or municipal office in your area, or visit the Bilingual Service Centre nearest you:
51 Rogers St, Notre-Dame-de-Lourdes MB
Unit A, 30 Dawson Rd, Ste Anne MB
Recreational Centre on Hwy 6, St. Laurent MB
427 Sabourin St, St-Pierre-Jolys MB
